May Flyer

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Community Breastfeeding Gathering Registration

Please fill out the form below
or call (414) 617-3441 to register for the next Community Breastfeeding Gathering.

Name *
Name
Date of Birth
Date of Birth
Phone *
Phone
Address *
Address
I am *
Expected Due Date (if applies)
Expected Due Date (if applies)
Is this your first pregnancy? (if applies)
Are you currently breastfeeding or providing breastmilk? *
Are you bringing a male guest? *
A separate session is held for male guests during the gathering with our Father Peer Advocate. This can be your husband, boyfriend, friend or support.
Free childcare is provided by the YMCA.
Please let us know which day you will be attending *
I wish to attend the CBG on: