Birth Boot Camp Comprehensive Registration
Event Timing: Mondays, January 27th-March 30th @ 6pm
Event Address: 15448 FM 156 S Justin, TX 76247
Contact us at (817) 456-9353 or ktemple@birthbootcamp.com
Names (Mom and Dad) *
Your answer
Email *
Your answer
Phone Number *
Your answer
Please tell me a little about any previous pregnancies and births you've had. *
Your answer
Where do you plan to birth? Healthcare provider? Due Date? *
Your answer
Have you ever taken a childbirth preparation class before? If so, when and what type of class? *
Your answer
What are you hoping to learn from this class?
Your answer
I understand that a $50 non-refundable deposit is due at sign up in order to reserve my spot. *
Required
Payment Options
Please send credit card payments via PayPal to ktemple@birthbootcamp.com
Cash and major credit/debit cards accepted in person.
*Full balance ($350) is due the first night of class, please!
Submit
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy