Childbirth Education Registration
Congratulations on taking a vital step in preparation for your childbirth experience!

Please complete this form and I will contact you to schedule class time(s) that fits best for your family.
Full Name *
Email *
Estimated Due Date
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YYYY
Are you a first-time parent?
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Birth Location
Choose A Class Type *
Required
Preferred Learning Environment *
Disclaimer
The curriculum presented in class is intended for informational and educational purposes only and does not serve as medical advice, a basis for diagnosis or recommendation of treatment. Always seek the advice of your healthcare provider with any questions you may have regarding a medical condition or health concern. The information provided is based on the most current recommendation at the time of this presentation.

Hānau Doula is committed to helping ALL parents. I strive to use inclusive language in our curriculum. I welcome diversity and the opportunity to interact with all members of our community.
Electronic Signature to Hire and Pay
By providing your name below, you are signing this Childbirth Education Registration Form electronically. You agree your electronic signature is the legal equivalent of your manual signature on Childbirth Education Registration Form.

You are also agreeing to hire and pay Marnellie Bishop, Hānau Doula for Childbirth Education Services.
Client Full Name *
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