Birth Boot Camp Registration
Please fill out the form below to sign up for a childbirth education class.
**Your spot is not reserved until you submit your $50 deposit.**
Email address *
Which class would you like to register for? *
Required
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
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