* This Field is Required
SAFE BABY ACADEMY AGREEMENT
I realize registration for the Safe Baby Academy - Protecting Your Sleeping Baby class of Children's Hospital of Michigan is limited to those who are over 6 months pregnant or that are a caregiver of an infant less than 3 months old, and therefore I am qualified to attend.
I have not previously received a free Pack n' Play from any Children's Hospital of Michigan program, Department of Human Services (DHS) or Wayne County Department of Public Health.
I understand I must attend the entire class to be eligible to receive a Pack 'n Play.
I understand I am allowed to bring ONE (1) support person over 18 years of age, and NO CHILDREN are allowed in class.
The Safe Baby Academy - Protecting Your Sleeping Baby class will not allow any exceptions to the above terms and conditions.
I further understand that is ANY FALSE information is provided, I will not be eligible to attend any class by the Kohl's Injury Prevention Program in the future.
By checking this bow, I am confirming that all information is correct and I agree to the terms of the Safe Baby Academy - Protecting Your Sleeping Baby Participant Agreement.