Your Information

Name

Phone

Email

Town/City --- Select your Town/City --- Fort Erie Grimsby Lincoln Niagara Falls Niagara-on-the-Lake Pelham Port Colborne St.Catharines Thorold Wainfleet Welland West Lincoln

Breastfeeding Workshop Information

Baby Due Date

Desired Course Date --Select Date-- Dec. 6, 2011 - Niagara Falls, 6 - 8 p.m. Jan. 18, 2012 - St. Catharines, 6 - 8 p.m Jan. 24, 2012 - Grimsby, 6:30 - 8:30 p.m. Feb. 9, 2012 - Welland, 6:30 - 8:30 p.m. Feb. 23, 2012 - Port Colborne, 6:30 - 8:30 p.m. March 21, 2012 - St. Catharines, 6 - 8 p.m. March 29, 2012 - Niagara Falls, 6 -8 p.m. April 17, 2012 - Grimsby, 6:30 - 8:30 p.m. May 31, 2012 - Niagara Falls, 6:30 - 8:30 p.m. June 20, 2012 - St. Catharines, 6 -8 p.m. June 21, 2012 - Port Colborne, 6:30 - 8:30 p.m. July 12, 2012 - Welland, 6 - 8 p.m. Aug. 14, 2012 - Grimsby, 6:30 - 8:30 p.m. Sept. 20, 2012 - Welland, 6:30 - 8:30 p.m. Oct. 25, 2012 - Port Colborne, 6:30 - 8:30 p.m. Nov. 21, 2012 - St. Catharines, 6 - 8 p.m. Dec. 6, 2012 - Niagara Falls, 6 - 8 p.m.

Partner Attending? Yes   No

Partner's Name

Verify your Submission

Verify your submission by typing in the following 6-digits:

  Can't read it? Try a Different One

Verify Number * Required