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Deb's Course Booking Enquiry Form
Weekend courses with Registered Calmbirth Educator, Deb Peters in NZ.
Cost $495
(early birds, book 4 weeks before course starts $445).
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* Indicates required question
Email
*
Your email
Mother's Full Name
*
First Name and Surname please
Your answer
Baby's Expected Due Date
*
MM
/
DD
/
YYYY
Which Calmbirth Course are you interested in booking on to?
*
Indicate Month, Year and location here please
Your answer
Father's/Partner's/Support Person's Full Name
*
Your answer
Home Telephone
*
Landline - if applicable (please state n/a if do not have one)
Your answer
Mobile Telephone
*
Your answer
Your Home Address
*
Your answer
Who is your Lead Maternity Carer? (e.g. Midwife's Name, Obstetrician's Name? etc...)
*
Your answer
How did you hear about the Calmbirth course?
Midwife / LMC
Word of Mouth / Friend
Internet Search
Hospital Staff
Childbirth Education Classes
Advertising
Other:
Would you like?
*
Info to be sent to you by email?
To book on to a course right now?
Is there anything else you would like to let Deb know?
Your answer
A copy of your responses will be emailed to the address you provided.
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