BBC Comfort Measures Registration Form
Welcome! In an effort to use less paper and save time in class, I have created this google form for registration and introduction.

Payment: Is due upon registration. So within 3 days I will email you a PayPal invoice where you can pay using paypal or a credit/debit card. If you prefer a different form of payment, please email me. Payment is required to reserve your spot in the workshop.

*Please Note: The location of the group class is at Katie's home in Catonsville, MD near Woodbridge Elementary School (exact address will be a part of the welcome email coming shortly). I take every consideration possible for your comfort and needs and will address any specific requests you have. We do have a cat in our home; however, she will be kept in another room during class. I will clean as best I can before each class. If you are severely allergic to cats, please contact me directly. I may be able to utilize a back up location, refer you to another BBC instructor or offer you a private class.

Thank you!
Katie Tighe, Doula, BBCI, SpBPPE
Warmscarfdoula@gmail.com
864.356.3487

Please indicate the workshop date you wish to attend *
Mom's Name *
Your answer
Partner's Name (or whoever will be joining you at the workshop as your support person)
Your answer
EDD *
MM
/
DD
/
YYYY
Is this going to be your first birth?
Email (For: welcome email, invoice, follow up email and other important communications. NOT for newsletter or shared without permission. *
Your answer
Do you want to join the Warm Scarf Doula mailing list for updates and special offers? *
Cell Phone Number *
Your answer
Notes for Instructor
Your answer
Any allergies (in case I bring a snack to share)? *
Your answer
Coupon or Promo Code? (limited availability, MUST present the actual flyer or coupon to instructor at the beginning of class or discount will not be applied)
Your answer
How did you hear about this workshop? *
Required
Images courtesy of Birth Boot Camp. Thank you.
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