2021 ROC City Baby Cafe Virtual Holiday Gathering

Thanks for your interest in our event! Although our limit has been reached for individuals to receive a Meal to go and holiday tote, registration is still open to attend the event.

Please fill out the form below. All registrants have an opportunity to win a door prize/gift basket raffle.

You must be registered and present to win.

Name *

First

Last

Email *

Primary Home Address *

Address Line 1

Address Line 2

City

AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingState

Zip Code

Mobile Number *

Baby's Date of Birth *

Baby's Clothing Size *Select one0-3 months3-6 months6-12 months12-18 months18-24 months

Current Infant Feeding Status *Select oneHuman Milk feedingHuman Milk/Formula feedingN/A-Currenlty Pregnant

Due Date (if pregnant)

Delivering Hospital *

How did you hear about this event? *Select oneHospitalPediatric OfficeOB OfficeWICSocial MediaFriendOther

---

Please dress your baby in holiday attire. We will be taking group photos during our event.

Visit and LIKE the Rochester Regional Breastfeeding Coalition Facebook page by Dec. 3rd to receive an extra raffle ticket in your tote to win a gift basket during our event. Must be present to win.

Submit