Best Birth Forward: childbirth education series
REGISTRATION FORM:
8-week GROUP hybrid series
Dates/time: Sundays, May 5-June 23 | 6:30-8pm
Venue: Southend Community Centre | 1464 George Street | Sydney, NS
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The series will run Sundays, starting May 5 until June 23 from 6:30-8pm at the Southend Community Centre in the Mommy Connections Cape Breton community space. There will be a makeup class on June 30 should any classes need to be rescheduled. Please confirm that these dates/times work for you before proceeding.
*If NO, or if your schedule would mean missing more than 2 of the 8 classes, a private series or self-study stream may be better options for you! Return to https://www.belleviebirthandbaby.ca/prenatal-education for private series information.*
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Required
Please list your full name and personal pronouns. *
I recommend a partner/support person attend with you whenever possible. Ideally, this is the same person who will support you during birth (if applicable). Please provide their name/relation/pronouns, if relevant.
Most communication is done via email, but phone/text is used as a backup contact method. What is the best phone number to reach you?  *
Where in the CBRM do you live? Because group classes are currently in-person, you should be able to attend weekly. *If you are outside of the CBRM, a private series or self-study stream may be better options for you! Return to www.belleviebirthandbaby.ca/prenatal-education for private series information.* *
When is your due month? This series is best if you are due ideally July-October. If you are due June or earlier, a private series or self-study stream may be better options for you! Return to  www.belleviebirthandbaby.ca/prenatal-education for private series information. The next group series will likely be either September-October 2024 (depending on demand) as an option for those due November or later. *
Required
Who is your primary pregnancy care provider/doctor/OB (if known)?
What birth number is this for you?
Is there anything you would like to share about your history/pregnancy that might help me better meet your family’s needs and expectations?
Are there any pregnancy/birth/postpartum topics of particular interest for you?
Are there any special needs/accommodations (academic or other) I should know about prior to the course to better support you?
Sometimes snack and refreshments are provided. Do you/your support person have any dietary restrictions or allergies we should know about to accommodate?
There will be a private Facebook group for cohort class members for communication, updates, etc. Do I have your consent to add you to this group via e-mail invitation closer to the course start date? *
Required
Sometimes photos are taken during classes. Do we have your consent to take and possibly share these photos to help highlight/promote the series? *
Required
How did you hear about this course and/or Belle Vie Birth & Baby? This helps me to understand how I'm best reaching clients.
If you were referred by a friend, please provide their full name so I can thank them!
How will you be paying for the course? The full fee is required to confirm/hold your spot, unless otherwise requested. Thank you!

E-transfer: belleviebirthandbaby@gmail.com
Make password: bestbirthforward

*Registration confirmation will be sent via email upon receipt of both this form and your payment.*
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Required
CANCELLATION POLICY

a) If you are unable to attend after registering and payment is received, with the exception of special individual circumstances, there are no refunds available. The series running (venue booking/resources/supplies) depends on our anticipated registration numbers. However, we will hold your payment and allow you apply it to a *private Best Birth Forward series, a later group series, or future services/classes as credit.
*NOTE: Discounted 'Mom to Be' rate does not apply to a private series as it is a custom class—you would pay the $20 difference if switching to private format ($200).

b) If the series is cancelled due to low registration or other reasons on our end, you will be eligible to receive a full refund.

Please confirm below that you agree and accept the cancellation policy.
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Required
NOTE ON INSURANCE
While we cannot direct bill, some clients have recently had success with insurance companies allowing them to claim and get reimbursed for privately run childbirth education under their "other" category/benefits. It is worth looking into your particular insurance and inquiring. An official receipt can be provided with the necessary information if needed.
THANK YOU FOR REGISTERING! Do you have any questions you would like answered before/when we reach out to confirm your registration or discuss your payment options?
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