My Smart Hands - Parents' Registration
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| I've been invited to take a private class.
| May 22 start, East Van May 28 start, Downtown
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Personal Information
Adar Birth Services does not lend, hire, rent or sell personal information to other businesses.
Thank you for your trust.
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| Baby's/Babies' Name(s)
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| Baby's/Babies' Date of Birth
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| Photo of you and your baby.
| To help the instructor remember names and to add to your certificate when you've completed the First Level of My Smart Hands.
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| Do you have other children?
| Yes No
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| If yes, how many?
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| Parent 1
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| Parent 2
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| Email 1
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| Email 2
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| Phone 1
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| Please include all numbers you can be contacted at in case of any changes.
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| Phone 2
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| Phone 3
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| Apartment Number
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| Street Address
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| City
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| Postal Code
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| What made you choose Baby Sign Language?
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| How did you hear about My Smart Hands?
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| My caregiver told me My wellness coach (fitness, yoga, etc) Another poster or flyer Online Word of mouth Newpapaper Radio Other Please select all that apply.
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| What do you expect from Baby Sign Language classes?
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| Is there anything else you would like Aimée to know?
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| I prefer to pay by
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| Cash (in person only, receipt provided) Cheque (your chosen class date must be at least two weeks away and the cheque needs to be received within one week of registration) Online (a Paypal invoice will be sent to the first email address you provided above) If you are choosing to pay by cash, please call or email to arrange a time.
If you are choosing to pay by cheque, please make it out to Adar Birth Services and send to:
Adar Birth Services
1911 Kitchener St
Vancouver, BC
V5L 2W6
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| Checklist (for your convenience)
| If you are paying by cheque, is it signed, properly dated and made out to Adar Birth Services? Have you double-checked that the dates you have chosen work for your family? Thank you.
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Image Verification
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