Refresher Birth Class Registration

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Birth Boot Camp's Refresher Birth Class Includes:

*3 hours of in-person class time
*Review of the process of labor
*Hands-on practice of comfort measures, relaxation, and labor positions
*Information tailored to your needs & concerns
*Refresher Workbook
*Cost: $150 per couple

Mom's First & Last Name: *

Partner's First & Last Name:

Address: *

Email: *

Phone Number: *

Mom's Age: *

Estimated Due Date: *

YYYY

Name of Birth Place: *

Name of OB or Midwife: *

Name of doula (if applicable):

Briefly describe previous birth(s): *

What are your goals for this birth? *

Are there any special circumstances or concerns you have about your pregnancy or birth? *

How did you hear about Birth Boot Camp? *

How did you hear about me? *

**A non-refundable deposit of $50 is required to secure your class date and to cover the cost of materials. The remaining non-refundable balance of $100 is due at our class meeting. These may be paid by cash, check, Venmo or PayPal. You will receive an email with payment information after your registration form is received. I look forward to seeing you in class! *

I have read and understand that the deposit and class fee are non-refundable.

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