Prepared Mommy Camp Registration 2018
The 2018 Prepared Mommy Camp will be a series of Saturday workshops from 10am-2pm in Chauncey, Ohio.

Please fill out this form and click "submit" if you are interested in attending Prepared Mommy Camp this year. Once this form is submitted, the Birth Circle will contact you with more information. We are accepting registrations from moms and moms-to-be up to age 23. If you are older, your application will be considered if space is available. If you have any questions, call/text 740-652-6262 or email athensbirthcircle@gmail.com.

Which session of Prepared Mommy Camp can you attend? *
Name *
Your answer
Mailing address *
Street Address, City and Zip Code
Your answer
Email *
If you have no email address, write "none"
Your answer
Phone *
Your answer
Can we text you at this number? *
Required
How would you like to be contacted? *
Required
Emergency contact #1 *
name, phone number(s), email, relationship to you
Your answer
Emergency contact #2 *
name, phone number(s), email, relationship to you
Your answer
Your birthday *
MM
/
DD
/
YYYY
Your due date if pregnant
MM
/
DD
/
YYYY
Do you have other children? If so, what are their names and birthdays? *
Your answer
Who is your doctor/prenatal care provider? *
Your answer
Please list any food allergies/issues we should know about *
Write "none" if none are known.
Your answer
Do you need help with transportation to/from Camp? *
Your answer
Are there any special considerations we should know about? *
physical limitations, health issues, challenges you’re facing, etc
Your answer
What are you concerned about or thinking about, as you approach birth and motherhood?
Your answer
What are you most excited about?
Your answer
Anything specific you want to learn/do at Camp?
Your answer
Is your baby's dad/your partner interested in attending a group for young dads on one of the camp days? *
Submit
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