Your Name *

First Name

Last Name

Your Phone *

(###)

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Your Mailing Address *

Upon completion of the 3-day workshop, you will receive a FREE signed hardbound copy of the children's book WITH YOU to be mailed to your address.

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Partner's Name *

First Name

Last Name

Partner's Phone *

(###)

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We are *

Considering becoming parents

Expecting a baby

Parenting an infant or toddler age 0 to 3

Are you bringing baby? *

Babies in arms age 9 months or younger are welcome.

Yes

No

Checking the box below means you understand that Bringing Baby Home is not psychotherapy. *

Yes