Sibling Class Evaluation
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
*
Hospital
Free-standing birth center
Home
Are you planning to have your child(ren) attend the birth?
*
Yes
No
Undecided
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?
Yes
No
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!