Birth Boot Camp Basic Training Registration
7 Hour Class
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Which class date are you registering for?  *
Mom's Name
Mom's Occupation
Dad's Name
Dad's Occupation
Mom's Email
Dad's Email
Mom's Phone Number
Dad's Phone Number
Mom's Age
Estimated Due Date
Number of Children
Number of Medicated Births
Number of Unmedicated Births
Number of Cesareans
Number of VBACs
Where are you planning on having your baby?
Who is your care provider?
Are you planning on hiring a doula?
How did you hear about Birth Boot Camp?
How do you feel about taking Childbirth Classes?
What type of birth experience are you hoping for? (ex: unmedicated, medicated, waterbirth, homebirth, etc...Feel free to elaborate.)
How does your partner feel about taking Childbirth Classes?
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