With Love, Community Baby Shower and Maternal Wellness Expo

With Love, Community Baby Shower and Maternal Wellness Expo

For parents/caregivers who are expecting or have a baby under 6 months
Name

First NameLast Name
Email
example@example.com
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Zip Code
Gender
Race
Approximate Household Income
Household Size
Your Age
Who is your medical insurance provider?
Ex: Healthy Blue, BCBS, Aetna
What hospital do you plan to birth at? (Or where did you give birth?)
Ex: Woman's, Ochsner, etc
Will you be bringing your partner or support person as a guest? (Please only one guest)
How many children will you be bringing?
Space is limited so please only bring your little ones if necessary. You will have to keep them with you at all times.
How did you hear about this event?
Is English your primary language?
If English is not your primary language what is?
Do you understand that event space is limited and this event is for parents and caregivers who are pregnant/expecting or who have a baby under 6 months?
What is your child's birthday or due date?

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Photo & Video Notice - By attending this event, you acknowledge that photographs and video footage may be taken throughout the event. These images may be used for promotional purposes, including social media, website, and other marketing materials. By entering the event premises, you consent to your image and likeness being used in these materials without compensation or prior notice. If you prefer not to be photographed, please inform the event staff upon arrival.
Please select your preferred start time during registration and plan to arrive 10 minutes early to check in. Families will rotate through two educational sessions: Maternal Wellness & Nutrition and Car Seat Safety, followed by an opportunity to visit with community partners and vendors. Once you have completed both sessions and filled out your learning punch card, you will be able to receive your diapers and other goodies!
Select your start time
Should be Empty: