Class Registration
Complete this form to register for your Childbirth Class! I will contact you within 24 hours to confirm registration and give you more details.
Hybrid Class meetings can be virtual or in person!
All In person classes are held at:
Kansas CPR, Inc
712 S Kansas Ave, Ste 104
Topeka, KS 66603
Dates and times vary based on class type.
* Required
Email address
*
Your email
First and Last Name
*
Your answer
Partner's First and Last Name
*
Your answer
Email Address
*
Your answer
Phone Number
*
Your answer
Estimated Due Date
*
MM
/
DD
/
YYYY
Preferred Contact Method
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Text
Phone Call
Email
How did you hear about my classes?
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Internet Search
Social Media
Your Website
Referral
My Blog
Other:
What Class Are You Interested In?
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Comprehensive (10 weeks, everything you need to know course)
Hospital Course (6 weeks)
Home or Birth Center Course (6 weeks)
Basic Training (1 day course, in person only)
Food and Fitness (1/2 day course)
Homecoming (1/2 day course)
Comfort Measures (1/2 day course)
Breastfeeding: The Ultimate MRE (Online Course)
Reboot Refresh (For those who've taken a course before)
Required
What Style of Class are You Looking For?
*
Make sure to submit this form so I can connect with you! Use this link to sign up for your Online Only course:
https://bit.ly/2J5171X
In person
Hybrid (Online course with interaction and support from me weekly or biweekly)
Online Only
Required
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