First-Time Parent Membership form

Thank you for your interest in our First-Time Parent membership.

After you submit this form, our Membership Manager will be in touch within 1 to 2 weeks to confirm the month and year of your child's birth and collect a $75 fee.

Your membership will expire on the last day of the month when your child turns 1 year old.

Parent first name

This must be a parent or legal guardian.

Parent last name

Parent email address

Confirm email

Parent phone number

Preferred contact method

Phone

No Preference

Mailing Address

City/Town

State/Province

ZIP/Postal Code

(Optional) Secondary adult member FIRST name (not the child's name)

This can be a parent, grandparent, other adult family member, or caregiver. Children's names should NOT be listed.

(Optional) Secondary adult member LAST name (not the child's name)

This can be a parent, grandparent, other adult family member, or caregiver. Children's names should NOT be listed.

(Optional) Alternate/3rd adult member LAST name (not the child's name). Note that only two adults may visit with a child at a time with this membership.

This can be a parent, grandparent, other adult family member, or caregiver. Children's names should NOT be listed.

(Optional) Alternate/3rd adult member FIRST name (not the child's name). Note that only two adults may visit with a child at a time with this membership.

This can be a parent, grandparent, other adult family member, or caregiver. Children's names should NOT be listed.

Month and year of child's birthday

Month and year of child's birthday: Year

Month and year of child's birthday: Month

How did you hear about the First-Time Parent Membership program?

Do you have any questions or comments?