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Embracing Birth Class 
Please fill out this form to register for class. I will hold your spot in the class. You will receive a confirmation email letting you know this. 
You can pay for class ($150 per couple)
 via https://paypal.me/JodiBubenzer?locale.x=en_US
or 
Venmo  @Jodi-Bubenzer
If you need another way to pay, please reach out.
If you have any questions, please reach out! 608-444-8812 (call or text). Can't wait to meet you!!
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Email *
Name *
Partner's Name
Partner's email address (if they would like to be included in correspondance)
Choose your class (remember, class is in 2 parts. Part 1: In-Person, Part 2: Zoom) *
Best number to reach you *
Due Date you've been given *
MM
/
DD
/
YYYY
Any special circumstances you'd like to share with me?
How did you find out about this class?
What other classes or ways have you begun to prepare for labor, birth and postpartum?
What are a couple of things you really hope to get out of this class? (If you and your birth partner are both attending class, it would be great if both of you could answer.)
Any other things you would like me to know about you, your pregnancy, birth desires or postpartum planning?
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