Wasatch Mountain Birth Boot Camp
Please complete this form and I will be in touch with you within 24 hours to complete the final steps of your registration. Thank you so much!
What's your name
What's your partners name
How may I best contact you?
How old are you?
When is your estimated due date?
How many children do you have?
This is our first
If you have given birth before, what kind of birth experiences have you had? (mark all that apply)
Where are you planing on giving birth?
Do you have any pre existing medical conditions? (Diabetes, Multiple Sclerosis, ect)
If yes, what conditions do you have?
Which class(es) would you like to register for?
10 week comprehensive class (July-September)
10 week comprehensive class (October-December)
10 week comprehensive class (January-March)
Hospital class (July 25th-August 29th)
Hospital class (privet)
Comfort measures workshop (privet)
Sibling class (privet)
Would you like to schedule a free doula consultation?
How did you hear about me?
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