Me Breastfeed Workshop Registration — Cambridge Memorial

Please select the date of the 2-hour workshop that you are registering for:
—Please choose an option—Wednesday, June 11, 2025 6-8pm VIRTUALSaturday, June 21, 2025 Early ON Water, Cambridge 10am to 12pmWednesday, July 9, 2025 6-8pm VIRTUALWednesday, August 6, 2025 6-8pm VIRTUALSaturday, August 16, 2025 Early ON Oak Creek, Kitchener 10am to 12pmWednesday, September 10, 2025 6-8pm VIRTUALFull Please Do Not Register Saturday, September 13, 2025 Early ON Water, Cambridge 10am to 12pmWednesday, October 8, 2025 6-8pm VIRTUALSaturday, October 18, 2025 Early ON Roger, Waterloo 10am to 12pmWednesday, November 5, 2025 6-8pm VIRTUALSaturday, November 8, 2025 Early ON Oak Creek, Kitchener 10am to 12pmSaturday, December 13, 2025 Early ON Water, Cambridge 10am to 12pm

Please select your due date month (we recommend taking this session in your final 2 months of pregnancy):
JanuaryFebruaryMarchAprilMayJuneJulyAugustSeptemberOctoberNovemberDecember

First Name *

Last Name *

Email *

Name of Person Who Will Attend With You *

By checking this box, you are giving permission for the Breastfeeding Buddies Program to receive this form via email and use your email address to communicate with you. While all precautions are taken to ensure security and privacy, email can be vulnerable to misuse. Please do not include any confidential health information on the form.

By Checking This Box you confirm you have registered for a KEyON Account**
KEyON is a digital sign in system that that is mandatory in order to attend family programming at any Early ON Centre in Ontario. (Early ON Centres are welcoming places that offer a range of services and resources, where you can: join fun activities such as reading, storytelling, sing-alongs and games. get advice from professionals trained in early childhood development. find out about other family services in your community).

For Child and Family Safety, each parent (to be) who is attending our class at Early ON Centre, will need to register for a Free KEyON Account. If you are attending the class with a support person, they will need to show government issued I.D. to attend.

To register for an Early ON account, please follow this link and then return to this page to complete your registration for your Prenatal Workshop. https://www.keyon.ca/en/Account/Register

** If this is a barrier for you, please email bfbuddies@healthcaringkw.org and we will find an alternate solution. [/KEyON]

Phone Number *

Postal Code *

We want to know who we're reaching! Please select city or township you live in most often:
CambridgeKitchenerWaterlooNorth DumfriesWellesleyWilmotWoolwichOutside of Waterloo RegionPrefer Not To Answer

How did you hear about the Me? Breastfeed Workshop? Please check all that apply.
Family/FriendRegion of Waterloo Public Health (Website, Nurse, Program)Attended the Prenatal Preview session at Blue HeronMidwifeDoctor/Nurse PractitionerObstetricianOntario EarlyOn CenterGrand River HospitalCambridge Memorial HospitalCommunity Healthcaring KWBreastfeeding Buddies WebsiteBreastfeeding Buddies Prenatal PathwaySocial Media (Facebook, Instagram, Twitter)Print Media (Poster, Pamphlet, Postcard)North/West Lambton CHCGuelph CHCNone of the Above

Why do you want to attend the Me? Breastfeed Workshop? Please check all that apply.
[checkbox why-attend "I want more information about breastfeeding" "I need help with breastfeedin]()

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