Report a Birth or Adoption

Do you know someone who recently had a baby? If you would like to have a Shalom Baby visit for your new bundle of Oy!, simply fill out the form below and a representative will be in contact with you.

Parents Names*
First Last
First Last
Phone*
Email*
Address*
Street Address Address Line 2 City State ZIP Code
Baby's Name*
First Last
Baby's Gender*
Baby's Date of Birth*
MM slash DD slash YYYY
How did you hear about Shalom Baby St. Louis?*
if Other, please explain
Phone
This field is for validation purposes and should be left unchanged.

Report a Birth or Adoption

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