Mā te Mātau Registration Form

To register your interest for Mā te Mātau, please fill out your details below. Please note spaces are limited and priority will be given to those closest to their due date. We recommend attending between 20-38 hapū.

Last name:

First name:

NHI: (If known)

Your date of birth:

Due date:

Preferred wānanga date to attend?

Email:

Phone number:

Other phone number:

Postal address

Your ethnicity: (eg Māori, Pakeha, etc)

Your midwife's name:

Do you have any allergies to food or medicines?

If yes, please provide details:

We encourage you to bring a support person with you

Name of support person:

Support person's phone:

Does your support person have any allergies to food or medicines?

If yes, please provide details:

Photographs may be taken throughout the programme. Do you consent to photos being taken and used for promotional material?
Yes No

Whats the best way to contact you?

Do you require any assistance such as wheelchair access, hearing support etc?

Last updated: Friday, February 24, 2023