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  Registration Form  
     
  Free Membership
Registered members will receive

$100 worth of spa voucher
Enjoy discounts at maternity shops, baby apparels outlets and baby specialty stores
Exclusive invitation to free or discounted workshop and seminars		  
     
  GIFT SUBSCRIPTION FOR NEW & EXPECTING MUMS*  
  Choose another 2 gifts options  
     Pre/Post-Natal Body Massage worth S$120
Baby Bath Care
Baby Milk Powder
Baby Diapers		  
   
  
  PERSONAL PARTICULARS  
     
 
Name :
NRIC :
Date of Birth :
Contact No. :
Mobile :
Email :
Address :
No. of Children :
     
Expected Due Date
(If pregnant)		 :
Hospital :
   
 
     
  *Please contact us at 6560 9193 on the date of admission. The gift hamper will be delivered to your ward on the following day. Complete the form and fax it to 6560 9391 or email to marketing@rusticnirvana.com.  
  Rustic Nirvana Pte Ltd reserves the right to substitute the free gift for another of the same or greater value should the gift item is out-of-stock.