Royal Mum Registration

* = Required Information

Details of Royal Mum

Title*

First Name*

Current Surname*

Surname to Appear on Honour Wall (if different from above):

Royal Mums Date of Birth (for security checks only)*

Current or last known address of the Royal Mum

Street Address or PO Box*

Suburb/Town*

State*

Postcode*

What is your relationship to this Royal Mum?*

Is this Royal Mum deceased?

Royal Mum's contact details

Royal Mum Contact Phone*

Royal Mum Email*

Details of Person Completing the Registration Form

Title*

First Name*

Surname*

Street Address or PO Box:*

Suburb/Town:*

State:*

Postcode:*

Contact Phone*

Email*

Have you also registered yourself as a Royal Mum?

Details of Royal babies

List the name and year of birth of each baby

Baby 1 Details

Baby First Name*

Year of Birth*

Sex*

Was this baby born premature?

Additional Information

Do you have a Royal Mum story that you'd like to share?

I have read and agree to the privacy policy *

In accordance with the latest amendments to the Information Privacy Act, RBWH Foundation will contact any Royal Mum newly registered by someone other than themselves in order to gain their direct permission to have their name included on the Royal Mums Online Honour Wall and the Honour Wall displayed at the hospital. Once this approval has been received, the Royal Mum will be immediately published on the Online Honour Wall and included in the next update of the hospital Honour Wall