Deb's Course Booking Enquiry Form
Weekend courses with Registered Calmbirth Educator, Deb Peters in NZ
Mother's Full Name
First Name and Surname please
Baby's Expected Due Date
Which Calmbirth Course are you interested in booking on to?
AUGUST 2017 on WAIHEKE ISLAND (Saturday 12th & Sunday 13th)
SEPTEMBER 2017 in AUCKLAND (Saturday 16th & Sunday 17th)
OCTOBER 2017 on WAIHEKE ISLAND (Saturday 21st & Sunday 22nd)
NOVEMBER 2017 in AUCKLAND (Saturday 18th & Sunday 19th)
DECEMBER 2017 in AUCKLAND (Saturday 2nd & Sunday 3rd)
Father's/Partner's/Support Person's Full Name
Landline - if applicable (please state n/a if do not have one)
Your Home Address
Who is your Lead Maternity Carer? (e.g. Midwife's Name, Obstetrician's Name? etc...)
How did you hear about the Calmbirth course?
Midwife / LMC
Word of Mouth / Friend
Childbirth Education Classes
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?
A copy of your responses will be emailed to the address you provided.
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