Birth Boot Camp Registration
Please fill out the form below to sign up for my next 10-week series.
**Your spot is not reserved until you submit your $50 deposit.**
Email address
Name
Your answer
Phone Number
Your answer
Age
Your answer
Estimated Due Date
MM
/
DD
/
YYYY
Partner's Name
Your answer
Number of Children
Your answer
Previous Births (check all that apply)
Required
Where Are You Planning to Have Your Baby?
Care Provider
How did you hear about this class?
Required
How do you feel about taking a childbirth class?
Your answer
How does your partner feel about taking a childbirth class?
Your answer
I understand that $50 is due upon sign up to reserve my spot
Required
Please complete the captcha before submitting the form.
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