Birth Boot Camp Comprehensive Course 10 wks
Welcome to Birth Boot Camp! I'm so pleased that you've decided on the Birth Boot Camp curriculum. It's modern, up to date, and comprehensive! I'm confident it will lead you to the birth you desire! A $50 non-refundable deposit is due at the time of registration to hold your spot and purchase your materials. You may use paypal.me/fresnobirth , I can send you an invoice, or mail me a check. (email lchastain@birthbootcamp.com ) The balance $300 will be due at the first class unless payment plan has been established. (Ask me about our payment plans! :) )
Class Dates *
Mom's Full Name *
Your answer
Support Person's Full Name *
Your answer
Address *
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City *
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Zipcode *
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Email *
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Cell # *
Your answer
Age *
Your answer
Estimated Due Date *
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Number of Children *
Your answer
Number of Medicated Births *
Your answer
Number of Unmedicated Births *
Your answer
Number of Cesareans *
Your answer
Number of VBACS (Vaginal Birth after Cesarean) *
Your answer
Where are you planning to have your baby? *
Your answer
Do you have a care provider? If so who? *
Your answer
Who can I thank for referring you to Birth Boot Camp? *
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How do you feel about taking childbirth classes? *
Your answer
How does your support person feel about childbirth classes? *
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I understand that the $50 deposit is NON-REFUNDABLE. Once the deposit is paid and the registration form is submitted, a spot in class is reserved for you AND your student Birth Boot Camp materials are purchased. *
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