Baby Teeth Course – Registration Form

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Only a very limited number of seats are available for this year’s course. To help us make room for everyone who would like to attend, please register only if you are planning to join us. Once you register, a seat will be reserved for you. If your plans change, we kindly ask that you let us know as soon as possible so we can offer your spot to another family.

Event Details
📅 Thursday, September 24
🕠 5:30 PM
📍 Sovereign Dental Kids – Parkdale
3-1101 Arthur St W, Thunder Bay, ON P7E 5S2

Email *

Full Name *

Phone Number
(We’ll use this number only for event reminders and important updates) *

Address

Are there any medical conditions we should be aware of? (Yes/No – please specify) *

Do you have any allergies? (Yes/No – please specify)
*

What would you most like to learn about?

When babies should first see a dentist

Brushing and caring for baby teeth

Preventing cavities/bottle decay

Teething

Dental costs/coverage

Other:

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How did you hear about this course?

Facebook

Instagram

Sovereign Dental clinic

Friend/family

Healthcare provider/community organization

Poster/flyer

Other

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Attendance confirmation *

I understand that space is limited and I am reserving a seat for this free course. If I can no longer attend, I will let Sovereign Dental know so my seat can be offered to another family.

Required

Reminder permission *

Yes, I would like to receive a reminder by text/email before the event.

A copy of your responses will be emailed to the address you provided.

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