Tauranga Parents Centre - Childbirth Education Course Enrolment Form

Course Address: Classes are held at the Tauranga Parents Centre Rooms at Building Number 29, Village on 17th, 17th Avenue West.
Contact us at taurangapc@xtra.co.nz
Course Start Date Request (this will be confirmed once your enrolment has been reviewed) DAY/MONTH/YEAR format - We recommend a class that ends when you are about 36 weeks pregnant. *
MM
/
DD
/
YYYY
Mother's Name (First and Last) *
Your answer
Partner's Name (First and Last) *
Your answer
Email *
Your answer
Phone Number *
Your answer
Expected Due Date (day/month/year) *
MM
/
DD
/
YYYY
National Health Index Number (Available from your midwife of GP- it may be on paperwork from your midwife) *
Your answer
How did you hear about our Parent Centre Childbirth Education Classes? *
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