Getting to Know You
Please complete the following questions so that we can get to know you better! We will need a separate form for each child in the service.
If any of this information changes, you may email diaperfairyinfo@gmail.com and we will be sure to update our records!
Email address *
Child's Last Name
Your answer
Child's First Name
Your answer
Parent One - Last Name
Your answer
Parent One - First Name
Your answer
Parent Two - Last Name
Your answer
Parent Two - First Name
Your answer
Delivery Street Address
Your answer
Delivery Zip Code
Your answer
Phone Number (in case we have questions about your order)
Your answer
Due date (or birth date) of child
MM
/
DD
/
YYYY
Child's Gender
Child's current weight (used for sizing)
Would you like to include cloth wipes in your weekly order? (40 wipes for $2 each week.) Please indicate quantity.
Your answer
Would you like to include rental covers in your weekly order? ($1 per cover per week.) Please indicate quantity.
Your answer
I will be attending the How to Cloth Diaper with the Diaper Fairy on the following date: (offered every Monday 12:00 - 1:00 and 6:30 - 7:30, and every Saturday 1:30 - 2:30.)
Your answer
How did you hear about Diaper Fairy?
Did someone refer you to The Diaper Fairy? Have a coupon code? Let us know here!
Your answer
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