Mums & Bubs Group - Babies 0

1

Your full name* This field is required.

First Name

Last Name

2

Email address* This field is required.

example@example.com

3

Phone number

Please enter a valid phone number.

4

Are you new to the area?* This field is required.

Yes (less than 12 months)

No

Prefer not to answer

5

Relationship to baby* This field is required.

Mother

Father

Carer

Other

6

Baby’s Name* This field is required.

7

Baby’s Age* This field is required.

0–3 months

3–6 months

6–9 months

9–12 months

8

Is this your first baby?* This field is required.

Yes

No

Prefer not to answer

9

If no, How many children do you have?

10

Will you be attending any of the following sessions?* This field is required.

Tuesday 30th June - Whitsunday Neighbourhood Centre - 9.30am to 11.00am

Tuesday 7th July - Whitsunday Neighbourhood Centre - 9.30am to 11.00am

Wednesday 15th July - Coffee Catch-Up (venue details to be confirmed) - 9.30am to 11.00am

Friday 24th July - Wear your PJ's - Whitsunday Neighbourhood Centre - 9.30am to 11.00am

All sessions

No

12

If No: Would morning or afternoon suit you best ?

Morning

Afternoon

13

If No: What would you rather?

Weekly

Fortnightly

Monthly

Other

14

Other

15

Where would you like to meet up?* This field is required.

Whitsunday Neighbourhood Centre

Local park

Local coffee shop

Local playground

Your suggestion?

16

Your suggestion?

17

Do you have any accessibility needs we should be aware of?* This field is required.

Yes

No

18

If yes please explain

19

Photo Permission - We may take photos during these sessions to share on our social media and promotional materials. Are you happy for your photo to be taken?* This field is required.

Yes

No

20

Would you like to be notified of upcoming activities / sessions / workshops?* This field is required.

Yes

No

21

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