Birth Boot Camp: Training for an AMAZING Hospital Birth
Class Dates: Every Thursday Nov 29-Jan 3, 2019
Class Time: 6-8:30pm
Location: The Happy Mama Place, Wilkes Barre Pa
1325 North River Street, Plains, Pa 18702 (Tuft-Tex Complex) (Your GPS may say Wilkes Barre)
Contact Info: Heather Whitcomb (570)542-2229, Heather@ButterflyDoula.com,
Cost: $250


Full class description and other class options can be found at www.ButterflyDoula.com/childbirth-classes/

Financial Agreement
The cost of this class is $250. A non-refundable deposit of $75 is due with your registration. This deposit can be made through PayPal or a check sent in the mail. The balance is due at the beginning of the first class. You may pay the balance by cash or check by mail, paypal or with a credit card in person at the first class. Any refunds given after the first class will be at the discresion of the instructor. By completing this form you are agreeing to these financial terms.

Please make checks payable to Butterfly Birth Services LLC.

Payments can be mailed to,
Heather Whitcomb
33 Elmer St
Ashland, Pa 17921

Paypal address Heather@ButterflyDoula.com

Email address *
Mother's Name *
Your answer
Partner's Name *
Your answer
Address *
Your answer
Phone Number *
Your answer
Estimated Due Date *
MM
/
DD
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YYYY
What hospital have you chosen to give birth at? *
Your answer
Who is your care provider? *
Your answer
What do you hope to learn in class? *
Your answer
How did you hear about this class? *
If you were refered by someone, who can I thank?
Your answer
How would you like to pay for this class? *
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