Baby's Name:

Sex (Choose one):
Male Female

Date of birth:

Weight (lbs./ounces):

Hospital:

Mothers' Name:

Father's Name:

Parent's City:

Address:

Names of other siblings:

Brothers (include their ages):

Sisters (Include their ages):

Grandparents (give city and state of each) living or deceased:

Living great-grandparents (Give city and state of each):

Living great-great-grandparents (Give city and state of each):

Person submitting information:

Daytime phone number:

Email address:

If you have any questions or comments you may contact the Lifestyles department at (704) 797-4271 or email us at lifestyles@salisburypost.com

Send all faxes to the Lifestyles department at (704) 639-0003.