Parent's Name:
Parent's Age:
...
20 to 24
25 to 29
30 to 34
35 to 40
40 Plus
Baby's Name:
Baby's Age:
Are you a first time parent:
Yes
No
Email Address:
How did you hear about MFM:
Mom's Group (Please Specify Group)
Word of Mouth
Online (Please Specify Where)
Magazine Ad
On-Screen Ad
Advertising Brochure
Prenatal Class
Movie Poster
Flyer at Baby Show
Other
Specify:
Have you attended Movies
For Mommies:
Yes
No
If yes, how
frequently:
...
Every Week
Every Second Week
Every Third Week
Once a Month
Which Location (Primary):
...
Rainbow Cinemas (Promenade)
Rainbow Cinemas (Market Square)
Cinestarz Cinema (Mississauga)
Fox Cinema (Beaches)
Princess Twin (Waterloo)
Barrie Imperial Theatre (Barrie)
Rainbow Cinemas (Ottawa)
Rainbow Cinemas (London)
Rainbow Cinemas (Saskatoon)
Rainbow Cinemas (Regina)
Magic Lantern (Spruce Grove)
Duggan Cinemas (Camrose)
Rio Theatre (Vancouver)
Montreal Beloeil
Montreal St. Eustace
Primary reason for choosing
that location:
...
Only Location in My City
Walking Distance from Home
Short Driving Distance from Home
Availability of Parking
Film Being Screened that Week
Other
Secondary reason for choosing
that location:
...
Walking Distance from Home
Short Driving Distance from Home
Availability of Parking
Film Being Screened that Week
Other
Reason
for attending Movies For Mommies:
...
See a Movie
Meet Other New Parents
Just Get Out of the House
Other
Specify:
Favorite type
of movie:
...
Romance
Drama
Thriller
Comedy
Foreign
Other
Specify:
What do you
like best about Movies For Mommies:
Movies For
Mommies would be even better if...:
Additional
programming you'd like to see from Movies For Mommies:
...
Brief Speaker Before the Show
Brief Speaker after the Show
Product Demonstrations
Information Handouts
Other
Specify:
Parenting resources
you read:
...
City Parent
Help We've Got Kids
New Parent Magazine
Westcoast Families
B.C. Parent
Today's Parent
Urban Baby
Other
Specify:
Parent / baby
activities you attend:
Mommy Baby Fitness
:
Specify:
Gymboree
Mommy baby music
:
Specify:
Postnatal Class
:
Specify:
Baby Yoga
:
Specify:
Parent infant Drop-in
:
Specify:
Baby Swimming
:
Specify:
Library Program
:
Specify:
Other
:
Specify: