Birth Boot Camp Registration
This registration form must be completed to reserve your spot in class.
Name *
Your answer
Partner's Name *
Your answer
Email Address *
Your answer
Phone Number *
Your answer
Due Date *
Who is your Care Provider? *
Your answer
Where do you plan to deliver? *
Which class are you planning to attend? *
Are you or your partner active Military?
How much would you like to be invoiced now? *
The total cost of this course is $350 ($315 for active military). A $50 (non-refundable) deposit is required to reserve your spot in class.
How did you hear about my class? *
Referred by a Friend? Let me know who I can thank :)
Your answer
What do you hope to learn/take away from this course?
Your answer
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