Sacramento Cornerstone Childbirth Class Registration Form
Congratulations on your pregnancy and thank you for your interest in our childbirth education classes! Please complete the following information. We'll follow-up with an electronic invoice once we receive your registration form. Once payment is in place, we'll follow-up with more class information and a link to our online classroom. We're very much looking forward to having you in class!
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Expectant Person's Name and pronouns used (she/her, he/him, ze/zem, fae/faem, etc):
Expectant Person's Email Address:
Expectant Person's Phone Number:
Partners' Name(s) (if applicable) and pronouns used (she/her, he/him, ze/zem, fae/faem, etc) - list all individuals who will be in attendance:
Partners' Email Address(es) (if applicable)
Street address - we will need to either ship or drop-off a small box of materials for class.
Estimated Due Date
Please indicate your birthing location (example: name of hospital, name of freestanding birth center, or "home")
Which class series are you registering for?
8-week November 1 - December 20, 2021 from 6:00 - 8:30pm
4-week January 8 - 29, 2022 from 10:00am - 3:00pm
8-week January 10 - February 28, 2022 from 6:00 - 8:30pm
4-week March 5 - 26, 2022 from 10:00am - 3:00pm
8-week March 7 - April 25, 2022 from 6:00 - 8:30pm
8-week May 2 - June 27, 2022 (skip 5/30) from 6:00 - 8:30pm
4-week June 4 - 25, 2022 from 10:00am - 3:00pm
8-week July 11 - August 29, 2022 from 6:00 - 8:30pm
4-week August 6 - 27, 2022 from 10:00am - 3:00pm
8-week September 12 - October 31, 2022 from 6:00 - 8:30pm
4-week October 8 - 29, 2022 from 10:00am - 3:00pm
We offer a sliding fee scale from $100 - $500. Please consider your budget and indicate how much you are able to pay for our 20-hour course, and we will follow-up with an invoice. No questions asked. Should you like to request a payment plan, let us know! (your balance must be paid in full before your class starts)
How did you hear about us?
My care provider
Word of mouth
Please indicate your goals for the class.
Please let us know if there's anything you'd like us to be aware of in order to help you feel comfortable and at home in our class. (for example, "I am d/Deaf or hard of hearing and would like to request live captioning" or "I am introverted and do not wish to participate in group activities while on camera.")
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