Becoming A Mom Registration for 2023/2024 Classes
Event Address: 350 S Range Ave., Colby, KS 67701 - Conference Room
Contact us at 785-460-4596 or ljackson@thomascountyks.gov 

You will receive an email with the paperwork that is required for the class on the Tuesday prior to that session starting. 
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Email *
What are the names of people attending, including yourself and your support person? *
What is your Date of Birth? *
MM
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DD
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YYYY
What is your due date *
MM
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DD
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YYYY
What is the name of your physician and the name of the clinic you see your doctor at? *
Phone Number *
What session are you registering for? 
All classes are 6 sessions on Thursdays from 6:30 pm - 8:30 pm  (dates are subject to change)
 *
Do you prefer to attend? (Pre-recorded sessions are available if this is the option that works best for you. You must contact TCHD after completing this registration for more information.) *
How did you hear about this event? *
What language do you speak *
Required
I consent to having the forms for Becoming A Mom® sent to me by text (SMS) or email and will be sent to the number or email listed above. 

Forms will be sent from an out of state number (850 area code) or an unfamiliar email address.
 *
A copy of your responses will be emailed to the address you provided.
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