|
BABY’S FULL NAME
(FIRST, MIDDLE, & LAST) |
BOY |
GIRL |
|
MOM’S NAME
(FIRST & LAST) |
DAD’S NAME
(FIRST & LAST) |
|
ADDRESS: |
|
|
E-MAIL: |
PHONE: |
|
DATE OF BIRTH |
PLACE OF BIRTH
(FACILITY &
CITY) |
|
WEIGHT
(lbs & oz) |
LENGTH
(inches) |
|
SIBLINGS
(NAME & AGE) |
|
Please forward this form (or just the
information) to John Evans at the Richfield Community Center: |
|
BY MAIL OR IN PERSON
Richfield Community Center
7000 Nicollet Ave
Richfield, MN 55423 |
BY FAX
612-861-9388 |
BY E-MAIL
Click here to submit info using
the website contact form. |
BY PHONE
612-861-9395 |