Conference Intake Form

Maternal Minds Parenting Matters Conference 2024
Due to a high volume of registration, this conference is now FULL.

Please fill out this form if you would like to be added to the waitlist.
Conference Information

Join Us for Lunch and a Transformative Conference on Muslim Family Well-being and Community Connections!

Gain insight from Muslim professionals on mental wellness for your family and community through talks, panels, and interactive workshops. Discover practical tools to foster a supportive, well-rounded home environment.

To learn more, visit: https://www.maternalminds.org/events

For any questions, please contact us at 905-243-1046 or intake@maternalminds.org
Date: Sunday, November 24, 2024

Time: 11:30 PM to 3:30 PM

Location: Sherwood Community Centre, Room #4

Address: 6355 Main St W, Milton, ON
Your Information
Name*

First NameLast Name
Will your spouse (or any other family member over 18) be attending with you?*

YesNo
What is the name of your spouse / family member attending?*

First NameLast Name
If yes, please submit a separate registration form for each additional attendee over 18. We require one form per person attending.
Have you attended any of our programs before?*

YesNo
If yes, then please select all the programs you have attended:*

Mindfulness MeditationLiterary LoungeHolding and HealingNew Beginnings: Postpartum Support GroupOther
Unfortunately, participants of the Mindfulness Meditation program are not eligible to attend this conference. Please email us at intake@maternalminds.org.
Email*
example@example.com
Phone Number*
Please enter a valid phone number.
Is it fine for us to leave a message at this phone number?*

YesNo
Can we add you to our WhatsApp Announcement Group to receive the conference event agenda, updates, and complimentary parenting resources?*

YesNo
I confirm that I am over the age of 18. (Please note that this conference is for adults only).*

YesNo
Unfortunately, you are not eligible to attend this conference as it is open to adults only.
Ticket*

I acknowledge that admission to the conference will be confirmed once Maternal Minds emails me the final ticket.
Media Consent*

Your use of a ticket constitutes an acknowledgement of willingness to appear in photographs, motion pictures and videos taken in our Maternal Minds "Parenting Matters" conference and releases Maternal Minds from liability resulting from the use of such photographs, motion pictures or videos.
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Maternal Minds Parenting Matters Conference 2024

Conference Information

Join Us for Lunch and a Transformative Conference on Muslim Family Well-being and Community Connections!

Gain insight from Muslim professionals on mental wellness for your family and community through talks, panels, and interactive workshops. Discover practical tools to foster a supportive, well-rounded home environment.

Your Information