Host a #TBBreastfeeds Cut-Out!
As part of the #TBBreastfeeds campaign, the Tampa Bay Breastfeeding Task Force will be locating life-sized cutout images of breastfeeding women and families in strategic locations throughout the Bay area.

We welcome requests from local businesses, including WIC offices, grocery stores, hospitals, doctors offices, baby supply stores, etc. to host a cut-out for up to 30 days.

If your business would like to host a cut-out, please complete the form below, and the Task Force will get in touch with you.

Thank you for your interest in normalizing breastfeeding!

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Name of Business or Organization *
Name of person completing this form (organization representative): *
Title or Role at your organization: *
E-mail: *
Phone number: *
We would like to receive the cut-out on or around this date:
We would like to host the cut-out for a period of:
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We cannot guarantee which cut-out you will receive. Availability of a specific cut-out may depend on dates requested. You may indicate your first choice, and we will let you know if it is available:
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I understand that the breastfeeding cut-outs are the property of the Tampa Bay Breastfeeding Task Force, Inc. I understand that by offering to host a breastfeeding cut-out, I am responsible for making sure the cut-out is returned to the Task Force on an agreed-upon date. I agree to make sure that the cut-out does not get damaged or misplaced while it is in my possession. *
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