Inquiry form – Spinning Babies Parent class & photo shoot

Your inquiry

This form is to help decide who will be in the free Spinning Babies Parent Class on DATE in exchange for full photo image permissions. Some questions are to help me have a mix of participants for the photo shoot. Some questions are to be sure that this class will work for you, given the requirements of the photo shoot.

Contact information

Childbearing woman/person*

First Last

Email*

Phone*

Father/Partner name*

First Last

Father/Partner phone*

Estimated arrival date of your baby*

Questions for childbearing woman/person

Do you have high blood pressure?*

No
Yes

Pregnant women/persons with high blood pressure

Although you could participate in a regular Spinning Babies Parent Class, you would not be able to do all the activities for the photo shoot.

Do you have any restrictions on movement?*

Note if you have any restrictions on movement other than the normal adaptations of pregnancy?

No
Yes

Describe any restrictions on your movement

Will you be able to be in this position (with a helper), which may be challenging for some people?*

An image of a Forward Leaning Inversion was sent to you. Please look at this image to answer the following questions. Your partner will be trained in how to help you get in & out of position. You will find the image shared in the e-mail that that I sent you with this form link.

Yes
No

Comfort in being photographed*

Do you feel comfortable with all parts of your body, particularly your belly, hips and bottom, being photographed and shared? Do you feel comfortable wearing clothing that shows the shape of your belly, hips and bottom? You will be fully clothed for the whole session.

Yes
No

How tall are you?*

This helps me to know what size balls to have available.

Why do you want to take the Spinning Babies Parent Class?

Brief note

How did you learn about this free Spinning Babies Parent class?*

Doula referral
Midwife referral
Friend referral
Facebook page
Other

Please provide the name of the person who referred you*

In which facebook group did you find the posting for this free class?

Questions for dads/partners

Do you have any restrictions on movement?*

No
Yes

Describe any restrictions on your movement

Do you have restrictions on how much weight you can lift?*

Especially consider how your lower back feels if you are lifting weight In the range of 25-40 lbs

No
Yes

Restrictions on movement & lifting

Although you could participate in a regular Spinning Babies Parent Class, you would not be able to do all the activities for the photo shoot.

Agreements of parents

Only families that agree to each of the following conditions will be selected to participate in the free Spinning Babies Parent Class & photo shoot. By submitting this form, we agree to the following:

We are able to fully participate in class on DATE from 1:30 - 4:30pm.*

Families who are selected will be notified and sent location of class. Class will be held in Minneapolis near Riverside exit of I94.

Yes
No

I, the childbearing woman/person, will wear comfortable, fitted clothing in which my belly, hips and bottom can be seen.*

Yes
No

I, the childbearing woman/person, will fill out comprehensive intake forms prior to the class.*

Yes
No

We will fill out an evaluation form within two weeks after the class.*

An evaluation form will be sent to you. The results and comments in the evaluation will be shared with families.

Yes
No

We will share our birth story, with a focus on how Spinning Babies helped you prepare for birth and how you may have used Spinning Babies during your birth.*

An online birth story form will be sent to you later. You may share the parts that you choose to share.

Yes
No

We will sign release forms for the photo shoot, giving permission for use of all images to Catherine Burns of MamaBebe.*

Release forms will be provided at the beginning of the class

Yes
No

Optional: Send photo now*

Families who send a photo now will be more likely to be selected, in order to help create a mix of participants. If you are able, please send a photo of mother/pregnant person to Catherine@MamaBebe.org.

Yes
No

Thank you for inquiring

Thanks so much for inquiring about the Spinning Babies Parent Class & photo shoot. Families who are selected will be notified by Saturday at noon, or earlier if possible.