Reboot Refresher Class
By completing this form and submitting a $15, non-refundable, deposit, which goes toward your $75 fee, you will secure a spot in the class series marked below. You may pay via PayPal (paypal.me/BethHake) or a mailed check made out to Beth Hake (Email bhake@birthbootcamp.com for my address). The remaining $60 is due the beginning of class.
Which Reboot Refresher Class will you be attending?
Mom's Name
Your answer
Partner's Name
Your answer
Email
Your answer
Phone Number
Your answer
Estimated Due Date
MM
/
DD
/
YYYY
Number of Children (not including this one)
Your answer
Number of medicated births
Your answer
Number of unmedicated births
Your answer
Number of Cesareans
Your answer
Number of VBACs (Vaginal Births After Cesarean)
Your answer
How did you hear about the Reboot Refresher class?
Your answer
Make-up Class Policy: I, Beth, am an actively working doula. There is always a small possibility that I will be called to a birth on the morning of class. If this happens, I will notify you with a phone call. As a class, we will agree upon a date to make-up the class.
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