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Loving Arms Support Form 2025 
Thank you for contacting us! Please do not complete this form if you do not live in the Waikato, New Zealand.
All details will be kept confidential.

More than one child? ... Please register for each child on separate forms.
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Name of Recipient/Caregiver *
Email address of family *
Street Address for delivery including suburb (Motel Name and Room Number if applicable)

Town/City (Waikato NZ) *
Required
Do you have a dog? *
Contact Phone Number - Please note that if you do not supply a contact number we are unable to process your request.
Age *
Required
Ethnicity *
Required
Expected Due Date/Baby's Birth Date *
MM
/
DD
/
YYYY
Sex of Baby *
Required
Referred By *
Required
Item/Support Needed
Please note we only supply clothing items up to 2 years of age. 
 *
Required
Comment (Also include nappy size, shoe size and baby's weight)
If you are filling in this form on behalf of someone else please include your name, your role and contact phone number here. Also please ensure that you have the permission of the person you are registering.
We will do our very best to supply what you have requested but we rely on community donations of items, so unfortunately if we don't have it, we can't provide it. Please tick the box once you have read the above. *
Do you consent to being emailed a feedback form? *
If you have identified yourself as NZ Māori, if you know what Iwi you belong to please add below.
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