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Your address is required for tax receipts.
Number of adult meals?
Number of kids meals?
Dessert choices are Chocolate Cake and Cheesecake. 1 dessert per person. How many of each would you like?
Due to COVID restrictions we are limited to a specific number of pick ups per time slot. Therefore the following time slots have been filled to capacity and are no longer available: 5:00-5:30 and 5:30-6:00.
Preferred pick up time?
Street Address Line 2
We are not collecting payment/donations with this registration. Bring your gift on April 28th to the meal! When you pick up your meal we are accepting cash, cheques (to PVPCC), debit or credit.
First and Last Name
Due Date (approximate)
Birth Partner Name
Name of doctor or midwife
What are you hoping to learn?
Health or other issues we should know?