Event Registration

* Asterisk indicates a required field

Registration for *

Infant/Child Safety at Home Web Class

Date / Time *

Wednesday, July 27, 2022
7:15 PM - 8:15 PM

First Name *

Last Name *

Address Line 1 *

Address Line 2

City *

State

Zip Code *

Email Address *

Phone *

Spouse/Partner Name *

Dr *

Due Date *

First Pregnancy

Yes

Pregnant With

Single

Twins

Multiples

Are you enrolled in Hope Chest?

Yes

Notice: The Midland County Hospital District adopted a tax rate that will raise more taxes for maintenance and operations than the no-new-revenue tax rate. The tax rate will effectively be raised 5.431% and will raise taxes for maintenance and operations on a $100,000 home by approximately $2.96 (two dollars and ninety-six cents).

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