Sibling Class Evaluation

Please share your observations about your child’s reaction to the class.

Date of Class Date of Class * / MM / DD YYYY
Parent Name Parent Name * First Last
Email *
Child's Name Child's Name * First Last
Child's age *
Due Date Due Date * / MM / DD YYYY
Intended place of birth *
Are you planning to have your child(ren) attend the birth? *
What did you (the parent or care giver) enjoy most about the class? *
What did your child enjoy most about the class? *
During class, what was your impression of your child's attentiveness and interest? *
Please comment on your child's interest in any of the following topics:
1. The discussion of where the baby is now and what it can do.
2. The demonstration of the labor and birth with the birthing doll.
3. The video, "There's A Baby".
4. The newborn baby. *
In the days since the class, has your child given you any indication of what information has stuck? Please describe. *
Do you have suggestions for how this class can be improved?
May we contact you about being the guest family when your new baby is born?
Phone Phone * - ### - ### ####
Where do you live? (neighborhood) *
May we use some of your comments for class descriptions and/or marketing purposes? *

May we use some of your comments for class descriptions and/or marketing purposes? Yes! (OK to share my first name too!) Yes! (Please use only my initials.) No, I prefer not.
Yes! Please keep me updated about Penny's upcoming workshops, products & books!

Yes! Please keep me updated about Penny's upcoming workshops, products & books! Yes!