Inspired Sleep
inspiredsleepwithcat@gmail.com
www.inspiredsleep.co.nz
02108188705
Inspired Sleep Registration Form
Parent name(s)
*
Parent(s) occupations
Child's name(s) attending session.
Child DOB
Please select a month
January
February
March
April
May
June
July
August
September
October
November
December
Month
Please select a day
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
Day
Please select a year
2024
2023
2022
2021
2020
2019
2018
2017
2016
2015
2014
2013
2012
2011
2010
2009
2008
2007
2006
2005
2004
2003
2002
2001
2000
1999
1998
1997
1996
1995
1994
1993
1992
1991
1990
1989
1988
1987
1986
1985
1984
1983
1982
1981
1980
1979
1978
1977
1976
1975
1974
1973
1972
1971
1970
1969
1968
1967
1966
1965
1964
1963
1962
1961
1960
1959
1958
1957
1956
1955
1954
1953
1952
1951
1950
1949
1948
1947
1946
1945
1944
1943
1942
1941
1940
1939
1938
1937
1936
1935
1934
1933
1932
1931
1930
1929
1928
1927
1926
1925
1924
1923
1922
1921
1920
Year
Gender
Please Select
Male
Female
N/A
Siblings and ages.
Address
Street Address
Street Address Line 2
City/Postcode
State / Province
E-mail
*
example@example.com
Mobile Number
Courses
*
Please Select
Inspired Sleep for 0-6month old.
Inspired Sleep for 6-12month old.
How did you hear about the Inspired Sleep support programme?
Back
Next
How was your pregnancy and birth?
Any health/medical/development concerns you are aware of with your child?
Are their any family values and parenting philosophies that you feel fit with your family?
Is there a specific sleep situation you'd like to explore during this programme, or are you seeking a deeper understanding of sleep biology and connection with other parents?
Are you aware that I do not practice any Sleep Training or Cry It Out methods? These practices are not part of my sleep support. Please know that if you have sleep trained your child, I am not here to judge. We all do the best with the knowledge we have access too.
Submit
Should be Empty: