**WAIT LIST ONLY** North Star Birthing Services' Community Baby Shower Registration
This event is accepting Wait List Registrants only at this time. A FREE event to celebrate new and expecting parents in Lansing, MI and provide essential items and resources for their birth. All expecting or postpartum parents attending must complete this registration.
Do you understand that this registration is for WAIT LIST only and you will be contacted if more availability to attend the community baby shower opens up?
*
Yes
No
Name
*
First Name
Last Name
Email
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Date of Birth
-
Month
-
Day
Year
Date
Have you previously attended this Community Baby Shower?
*
Yes
No
Unsure
Do you live in Lansing, MI or Ingham county?
*
Yes
No
Estimated Due Date or Date of Birth of Child
*
-
Month
-
Day
Year
Date
Race/Ethnicity
*
Arab American/MENA
Asian American
Black/African American
Hispanic, Latin(a/o), Latinx
Native American
Pacific Islander
White
Other
Number of guests
*
Please Select
1
2
Just Myself
Are you in need of transportation assistance to event?
*
Yes
No
What concerns do you/did you have around your birth?
*
Health/safety of myself
Health/safety of baby
Childcare
Financial Stability
Partner/Family Support
Access to supportive healthcare provider
Access to a doula
Housing
Transportation
Other
Do you know what a doula is?
*
Yes
No
What items are you in need of for your pregnancy/postpartum for baby? (Please select top 4 items)
*
Baby Wrap
Baby Monitor
Laundry Detergent
First Aid Family Kit
Nursing/Breastfeeding Items
Bottles
Infant Bathing Items
Postpartum Essentials Pack
Baby Thermometer
Infant Care Kit
Car Seat
Other
What services would you be interested in learning more about?
*
Doula support
Childbirth Education
Lactation suppport
Pelvic Floor Therapy
Prenatal/Postnatal Massages
Nutrition Support
Contraceptive Options
Mental Health Support
Financial Counseling
Infant Massage
Childcare options
Housing Assistance
Other
Sex of Baby
Male
Female
Unknown/Prefer not to disclose
What is YOUR clothing size?
Will you need access to a lactation room?
Yes
No
Do you have any dietary restrictions or accommodations needed?
I understand that by attending, I agree to the release of photography granting North Star Birthing Services and contract photographers permission to record on photography film and/or video pictures of my participation at the community baby shower. I further agree that any of the material photographed may be used in any form, as part of any future online/website/social media post, publication, brochure, or other printed material used to promote North Star Birthing Services.
Yes
No
Signature
Continue
Continue
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