Mercy Stork Affair Pre-Registration

Thank you for your interest in Mercy Stork Affair. Please complete the following information to pre-register and be eligible for prize drawings.

You reserve the right to revoke your permission for Mercy to use this information by calling (515) 247-3050.
1. How did you hear about Mercy Stork Affair?
2. Are you currently expecting?
3. If you answered yes to the above question, what is your expected due date?
MM DD YYYY
Due Date:
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4. If currently expecting, where will you be delivering?
5. May we share your name with vendors who donated prizes?
6. Please provide your contact information.
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