Hospital Birth Class 6 Weeks
Once this form is submitted, I will send you a PayPal Invoice for the $50, non-refundable deposit. The remaining $250 is due the first night of class, and/or can be submitted via PayPal. Aim to start this class by 28-32 weeks.
Class Dates
Mom's Name
Your answer
Partners Name
Your answer
Address
Your answer
Email
Your answer
Phone #
Your answer
Texting OK?
Age
Your answer
Estimate Due Date
MM
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DD
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YYYY
Number of Children?
Your answer
Care Provider?
Your answer
Who can I thank for referring you to Birth Boot Camp?
Your answer
How do you feel about taking a birth class? *
Your answer
How does your Partner feel about taking a birth class? *
Your answer
Make-up Class Policy: I, Lacy, am an actively working doula. There is always a small possibility that I will be called to a birth on the night 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 this missed class *
I understand that the $25 deposit is NON-REFUNDABLE. Once the deposit is paid and the registration form is submitted, a spot in class is reserved for you AND your student Birth Boot Camp materials are purchased *
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