Registration Form for Birth Boot Camp Comprehensive 10 week
Welcome! You will find the same form in the back of your Field Manual on p. 179. In an effort to use less paper and save time in class, I have created this google form instead. You do not need to complete both copies of the form.

Please Note: The group class is located in Katie's home in Catonsville, MD near Woodbridge Elementary School (address will be sent as part of welcome email). This is also home to a lovely cat who will be kept in another room during class. I take will take your needs and comfort into consideration as I clean before each class. If you have any specific requests, please indicate them below. If you are severely allergic to cats, please contact me directly as I may be able to move the class to my backup location, offer you a private class in your home or refer you to another BBC instructor in the area.

PAYMENT: The first half of the payment is due upon receiving the PayPal invoice which will be emailed to you within 3 days. The remaining balance is due at the beginning of the first class in the series. If you cancel more than 48 hours before the first class, you will receive a full refund. If you cancel less than 48 hours before the first class you will not be liable for the remaining balance and you will NOT receive a refund of the first half of the balance paid.

Thank you!
Katie Tighe, Doula, BBCI, SpBPPE
warmscarfdoula@gmail.com | 864.356.3487

Please indicate which Comprehensive Series you wish to register for: *
Mom's Name *
Your answer
Partner's Name
Your answer
Address *
Your answer
Email (For: Welcome email, invoice, follow up emails and other important communication. NOT for newsletter unless otherwise granted permission.) *
Your answer
Do you want to join the Warm Scarf Doula newsletter email list? *
Partner's Email (If he/she would like their own copy of the weekly emails with reminders and follow up info)
Your answer
Cell Phone Number *
Your answer
Age
Your answer
Estimate Due Date *
MM
/
DD
/
YYYY
No. of Children
Your answer
No. of Medicated Births
Your answer
No. of Unmedicated Births
Your answer
No. of Cesarean Births and if applicable, VBACs
Your answer
Where are you planning to have your baby? *
Your answer
Who is your care provider? (Name and Profession: Dr., CNM, CPM, None?)
Your answer
How do you feel about taking childbirth classes?
Your answer
How does your partner feel about childbirth classes?
Your answer
Do you or your partner have any highly sensitive food allergies, such as nuts? Good to know for snack breaks. *
Your answer
Do you have any special accommodations or requests for yourself or your partner during class? Or Additional Notes for Instructor:
Your answer
Coupon/ Promo Code? (Limited Availability, please present physical flyer or coupon to Instructor at the first class.)
Your answer
How did you hear about this particular Birth Boot Camp series with Katie Tighe? *
Required
Thank you!
Check your email over the next few days, I will email you an invoice. A release of liability form will also be in the Welcome email for your review. Please contact me if you have any questions.
I look forward to working with you for the 10 week series! -Katie Tighe
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