Nurture & Thrive: Application

Welcome to Nurture & Thrive 💛

This event is hosted in honor of Black Maternal Health Week, a national week of awareness and action that highlights the urgent reality that Black women are 2–3 times more likely to experience pregnancy-related complications and death than their white counterparts—regardless of income or education.

These disparities are not due to individual choices, but to systemic racism, bias within healthcare, lack of advocacy, and inadequate support before, during, and after birth.

Nurture & Thrive was created because Black women deserve to be heard, protected, believed, and supported—and because healthy parents create healthy families.

Our objectiveis to:
• Raise awareness about Black maternal health disparities
• Provide advocacy-centered education and support
• Normalize conversations around mental health and postpartum care
• Strengthen the entire family unit, including partners and children
• Build community, connection, and pathways to ongoing support

This space is judgment-free, culturally responsive, and rooted in care.
Full Name *

First NameLast Name
Email*
Address*

Street Address

CityState / Province

Postal / Zip Code
Contact Number *
Please enter a valid phone number.Format: (000) 000-0000.
Date of birth *

MonthDayYear
Date
Below $15,000$15,000 – $29,999$30,000 – $49,999$50,000 – $74,999$75,000 – $99,999$100,000 and abovePrefer not to say
YesNo
YesNoNo, but I have recently given birth (within the last year)No, but I am supporting a new mother
If pregnant, what is your due date?

MonthDayYear
Date
If postpartum, how old is your baby?
YesNoMaybe
YesNoMaybe
Event Interest & Support Needs
Mental health & self-care supportParenting education & newborn careFatherhood & doula supportSafe sleep & infant safetyStretching & movement during/after pregnancyNutrition & healthy eating for moms and babies
Do you have any specific concerns or challenges regarding your pregnancy or postpartum experience that you’d like support with?*
Do you have any dietary restrictions for food provided at the event? *
Do you need any special accommodations to attend the event? (Type N/A, is not applicable)
YesNo
How did you hear about this event?
Agreement & Submission
I understand
Should be Empty:

Event Interest & Support Needs

Agreement & Submission