Education Registration Form

We are SO excited to be part of your pregnancy and birth team!

To sign up for our classes, please fill out the intake form below and follow the payment instructions.

Registration AND payment are required to secure your seat in class. If you are in need of a payment plan, please reach out to our team as soon as possible.

First Name

Last Name

Email

Dad's/Partner's Name (if applicable)

Dad's/Partner's Email (if applicable)

What is your estimated due date?

Is this your first birth?

Where are you planning to give birth?

Is a doula part of your birth team? If so, who is your doula?

How did you hear about us?

Which class(es) will you be attending? Required

Childbirth Education Course

Newborn Class

Breastfeeding Class

Comfort Measures and Positioning Class

Which course session date is the best fit for you? - Please contact us with any questions with chosing class dates

Message

I agree to terms & conditionsCancellation & Missed Class Policy

I understand that payment is due upon registraton. My seat will not be secured until payment is completed.

Photo & Video Release Form:

I understand and agree to the terms outlined in the Photo and Video Release Agreement.

I DO NOT agree to the terms outlined in the Photo and Video Release Agreement.

View Terms & Agreement

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