Please note that we will never sell or share your personal information to any third parties. This confidential information will only be used to contact you about our current studies. Parent(s)/Guardian(s) First and Last Name Contact Information Street Address City/Town Province Postal Code Phone Number Email Address Child 1 Information Child's First and Last Name Sex Assigned at Birth* Male Female Other… Enter other… Gender Gender Male Female Other… Enter other… Date of Birth Date of Birth: Year Year200820092010201120122013201420152016201720182019202020212022202320242025 Date of Birth: Month MonthJanFebMarAprMayJunJulAugSepOctNovDec Date of Birth: Day Day12345678910111213141516171819202122232425262728293031 Weeks Gestation ? Child 2 Information Child's First and Last Name Sex Assigned at Birth Male Female Other… Enter other… Gender Male Female Other… Enter other… Date of Birth Date of Birth: Year Year200820092010201120122013201420152016201720182019202020212022202320242025 Date of Birth: Month MonthJanFebMarAprMayJunJulAugSepOctNovDec Date of Birth: Day Day12345678910111213141516171819202122232425262728293031 Weeks Gestation ? Child 3 Information Child's First and Last Name Sex Assigned at Birth Male Female Other… Enter other… Gender Male Female Other… Enter other… Date of Birth Date of Birth: Year Year200820092010201120122013201420152016201720182019202020212022202320242025 Date of Birth: Month MonthJanFebMarAprMayJunJulAugSepOctNovDec Date of Birth: Day Day12345678910111213141516171819202122232425262728293031 Weeks Gestation ? Languages(s) child(ren) hear Type of Studies In Person Online Both How did you hear about us? Baby Show Email Facebook Library Participant Referral Web Search Other… Enter other… CAPTCHA This question is for testing whether or not you are a human visitor and to prevent automated spam submissions.