Infant Massage Registration Please fill out this form, and a member of our team will be in touch with you! Today's Date* MM slash DD slash YYYY Please select the format you are interested in* Select All One-on-one sessions Group workshop Which setting would you prefer?* In-person at 110 Two Hills Dr, Carrboro, NC 27510 Virtual via Zoom Your Baby's Name* First Last Date of Birth* MM slash DD slash YYYY Baby's Age* Your name and relationship to baby?* Primary Phone* Email address* How did you hear about this group?* Is your baby receiving therapy or medical services? If so, where and what services?*Any allergies? If so, please list them. Please list any diagnoses (formal or informal) your child has:Are there any specific skills you are interested in learning through this workshop?We would love to tailor the experience to fit your interests and your baby's needs!If these dates aren't ideal for your schedule, please let us know what days and times you prefer. We are able to be flexible with group sessions.
