Mommy & Me PT Class Registration Your name * First Name Last Name Child's name * First Name Last Name Child's DOB * Child's DOB MM DD YYYY Email * Phone * (###) ### #### Child's Pediatrician Do you have any of the following concerns regarding your child's development? * Attaining certain motor skills Sleeping Eating/nursing Language Social/emotional General support for you & child Alignment/Posture Feel free to express any other concerns you have regarding your child's development here. How did you hear about Mommy & Me PT Classes? Thank you for your interest in Mommy & Me PT classes! Unless you learn otherwise, our classes meet the fourth Saturday of every month. Come as you are with your sweet babe. Also, please don’t hesitate to reach out in the meantime. I’m always happy to help however I can. Looking forward to connecting with you!Peace & love~Sara
