First-Time Parent Membership Application

07-First-Time Parent Member Application

PLEASE READ CAREFULLY: This membership is limited to first-time parents with a child (or multiples) under 18 months old. Membership will expire at the end of the month the child turns 18 months. (e.g., birth date 10/1/2022 would expire 4/30/2024). Families may enroll up to two named adults and qualifying infant (s). These names cannot be changed in the membership period. The Primary Adult must be the parent or guardian.

Primary Adult: (must be parent or guardian of child listed)(Required)

First Last

Cell Phone

Email Address: (The information you provide is used for WonderLab’s internal purposes only and is never shared with outside organizations. As a condition of this FREE membership, your email will be added to our email mailing list for announcements and communication).(Required)

Mailing Address(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Primary member's relationship to child: (Parent, grandparent, etc.)

How did you hear about this membership?

At WonderLab

Friend/Family

Doctor or Midwife's Office

Agency Office

WonderLab Emailings

WonderLab Website

Other

Second Adult: Can be a partner, or grandparent of child(ren). If there is no second adult, please just put "none" in the required fields.(Required)

First Last

Cell Phone

Email Address

Street Address (if different from Primary member)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Second adult's relationship to child: (Parent, grandparent, etc.)(Required)

Second adult's relationship to primary adult: (spouse, partner, parent, etc.)(Required)

Child's Name: (for twins, triplets, etc., use a comma)(Required)

First Last

Child's birth date: (Child must be under 18 months of age.)(Required)

Phone

This field is for validation purposes and should be left unchanged.