Seacoast 2018 United Way Community Baby Shower Registration

Get your baby off to a bright start!

Receive information and resources on child development, parenting, and community support, while meeting other new parents, enjoying brunch, and shopping in our boutique of gently-used items! Each new/expectant family will go home with items for your baby!

This event is for expecting moms or new parents with infants under 6 months, who are first-time parents or experiencing financial hardship. Each registered guest must live in the Seacoast region of New Hampshire or Kittery or Eliot, Maine and may bring one spouse/partner. (Registration is limited. Please note: registration does not guarantee attendance until you receive a confirmation.)

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* 1. Contact Information

First Name *

Last Name

Email Address *

Phone Number *

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* 2. The Community Baby Shower is for first or second-time pregnant women and/or parents with babies under 6 months, who live in the Seacoast region of New Hampshire or Kittery or Eliot, Maine. Please tell us are you...

first-time pregnant mom

have a newborn under 6 months

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* 3. So that we can provide a translator if needed, please tell us what language are you most comfortable speaking.

English

Spanish

Haitian Creole

Vietnamese

Other (please specify)

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* 4. While it is not guaranteed, we may be able to provide transportation to and from the event. Are you interested in receiving transportation home?

Yes, I am interested in finding out if a ride home is available.

No, I do not need a ride home.

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* 5. Photos, video, and/or audio recordings may be taken during the event. Please indicate below your permission to appear in pictures or video, or to be interviewed by the United Way.

YES, I agree to allow motion pictures, still photographs, videotapes, and sound recordings to be taken of me and/or my children, and to permit interviews to be taken of or about me and/or my children, by the United Way of Massachusetts Bay and Merrimack Valley, Inc. ("United Way"). I also agree that the aforementioned audio, visual, and/or written material may be used by the United Way for the purposes of advertising, promotion, or publicity. I waive and release for myself and my children all rights and claims for compensation of damages for such use of the aforementioned material.

NO, I do not want to be photographed, videotaped, and/or interviewed.

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* 6. You may bring ONE guest. They must be registered below in order to attend. Please provide their information here.

Full Name

Relationship to mom (husband, boyfriend, mother, sister, etc)

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* 7. You may bring children aged 10 and under. They must be registered in order to attend and sign into the children's play area. Please provide the first & last NAME and AGE of each child below.

NAME Child 1:

AGE:

NAME Child 2:

AGE:

Do they have any allergies?