Mindful Birth and Parenting Registration
Welcome to Mindful Birth!

Thank you for registering. If you have already paid the course deposit, please fill out this form.

If you would like additional information about classes, please email info@mindfulbirthny.com, or call 347.276.2819 (and please text if you miss me).

I highly recommend the comprehensive 8-week series, if at all possible. If you have to miss a session or two, it's not a problem. Let me know and I can give you options for making up the missed classes.

The intensives - also wonderful - primarily focus on labor. For those taking the weekend intensive, Babies, Newborn Care, and Parenting are sometimes available as a separate add-on. Please ask!

No matter which course you take, these classes offer practical, hands-on preparation for women and birth partners who are looking to work with labor and approach parenting as a team. The goal is for you and your partner to feel calm, well-prepared, and connected as you get ready for your child’s birth and the changes coming to your lives with parenthood.

I bring fifteen years of experience to an intimate setting that welcomes families birthing at home, in birth centers and hospitals.

I hope you can join us!

Warmest Regards,
Mary Esther Malloy, MA
Labor and Parent with Presence...
Which class series would you like to attend? *
Expectant Mother's Personal Info
First and Last Name *
Phone Number *
Email Address *
Full Postal Address *
Partner's Personal Information
First and Last Name
Phone Number
Email Address
Full Postal Address (if different from above)
About the Baby and Birth
Estimated Due Date *
MM
/
DD
/
YYYY
Midwife or Doctor? *
Name of Midwife or Doctor
Name of Doula if using doula care
Birth Location *
If planning on a birth center or hospital, which one?
Is this your first baby? *
If this is not your first baby, what are the ages of your older children?
How did you hear about this class? (If The Garrison Institute, please note here.) *
About You
These are some questions that will help me get to know you. Your responses can be super brief or pages long - however you would like to respond!
How is your pregnancy going?
How are you feeling about your upcoming birth?
How are you feeling about your doctor/midwife and where you're planning to give birth?
Will you be inviting others to join your birth team, such as mother, friend, sister, doula, etc.?
How do you see yourself coping well with your labor?
How ready do you feel to become a parent (or welcome yet another little one)?
Do you have any particular fears or concerns regarding birth or parenting that I should know about?
How was your previous birth experience (if applicable)?
Do you have any medical challenges I should be aware of?
What have you found to be a particularly inspiring resource for birth and/or parenting?
Deposit Payment and Agreement
To confirm your enrollment, please send a $100 non-refundable deposit for childbirth classes or $75 payment for refresher-specific classes via one of the methods below. Please email maryesthermalloy@gmail.com with any questions.
To confirm your enrollment, please return this form. If you have not yet sent a deposit of $100, please do so. The total fee for the childbirth class is $395 for weekend intensive, $525 for comprehensive series + practice intensive. The balance is due at the first class unless other arrangements are made. Refresher class students, please pay $100 in full for a refresher-specific class. The refund policy is as follows: the deposit is non-refundable. If after the first class you need to cancel, the initial deposit will be retained and any balance paid will be refunded, minus a $50 cancellation fee. Subsequent refunds/deductions after the first session will be not be available. Thank you for your understanding. Please let me know in writing if you would NOT like to be included in an email contact list with your classmates, which will be shared during and/or at the end of the class series. Also please let me know in writing if you do NOT approve my use of photographs taken during class for my website, and/or other promotional materials. *
Required
If you have not yet paid the deposit: How will you pay the $100 childbirth class deposit? (Doula clients only, please select "Doula Client Only" option.)
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