Prenatal Parenting Registration Parent 1 Full Name* First Last Parent 2 Full Name First Last Family Address* Street Address Address Line 2 City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Parent 1 Cell Phone*Parent 1 Email* Would you like to be added to our email list for future classes, programs and events?* Yes Please! No Thanks! Parent 2 Email Baby's Due Date* Date Format: MM slash DD slash YYYY Are you having more than one baby?*One babyTwinsTripletsMore than three babies are comingWhere are you delivering your baby(ies)?*Course SelectionPlease select all the classes you would like to attend. You can come to to one part or all four parts, you decide. All classes are Wednesdays 6:00-7:30pmPart One: The Amazing Talents of a Newborn March 3rd April 7th May 5th Part Two: Sleep, Cues, and Soothing March 10th April 14th May 12th Part Three: Exploring and Understanding Postpartum Depression March 17th April 21st May 19th Part Four: Infant Development in Year One March 24th April 28th May 26th Virtual Prenatal Parenting Agreement*I AgreeI understand that due to COVID-19, UConn Health Parenting Program is only providing this class via a virtual platform so I am required to have a computer and/or smartphone to attend. I agree to download Zoom to attend this series.