Comprehensive Series Registration
Mom's Name *
Your answer
Partner's Name *
Your answer
Address *
Your answer
Email *
Your answer
Phone Number *
Your answer
Estimated Due Date *
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Which series are you registering for? *
Are you or your partner allergic to any foods, or scents such as essential oils? *
Your answer
How did you hear about me/Birth Boot Camp? *
Your answer
Who is your care provider?
Your answer
How do you feel about taking a childbirth class?
Your answer
How does your partner feel about childbirth classes?
Your answer
Is there anything in particular you are hoping to learn from this series?
Your answer
I understand that I will not be considered registered for the Comprehensive: Complete Preparation for an Amazing Birth series until I have paid my deposit of $75. I understand that this deposit is non refundable. I understand that the remainder of the balance is due during the first class session, and is non refundable. I understand that if this is an issue I need to speak to Carol Meadows prior to the first class session and make arrangements. *
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