BBC Childbirth Course Registration
Complete this form to register for Birth Boot Camp classes with Sarah Kelchner. A $50 deposit is required to hold your spot; any remaining balance will be due at the beginning of class. Please send payment via PayPal to
or check or money order to Sarah Kelchner 3284 Thompson Road Cazenovia NY 13035
Which series do you plan to attend? (check ALL that apply)
Comprehensive Course (10 class series), March 31 through June 9, Sundays 4:00-6:30 pm $350
Comprehensive Course (10 class series), June 30 through September 1, Sundays 4:00-6:30 pm $350
Homebirth Course (2 day series), May 4 and 11, Saturdays 1:00-7:00 pm $200
Homebirth Course (4 class series), August 2-23, Fridays 6:00-9:30 pm $200
Hospital Birth Course (5 class series), May 3-31, Fridays 6:00-9:30 pm $225
Hospital Birth Course (5 class series), July 11-August 1, Thursdays 6:00-9:30 $225
Newborn Care Class, May 25, Saturday 12:00-4:00 pm, $85
Newborn Care Class, June 22, Saturday 12:00-4:00 pm, $85
Newborn Care Class, July 27, Saturday 12:00-400 pm, $85
Comfort Measures, April 20, Saturday 12:00-4:00 pm, $85
Comfort Measures, May 18, Saturday 12:00-4:00 pm, $85
Comfort Measures, June 25, Saturday 12:4:00 pm, $85
Early Pregnancy Class, April 9, Tuesday 6:00-8:00 pm, FREE
Early Pregnancy Class, May 7, Tuesday 6:00-8:00 pm, FREE
Early Pregnancy Class, July 9, Tuesday 6:00-8:00 om, FREE
Birth Partner's name and relationship, if applicable
Preferred Method(s) of contact
Care Provider and Planned Birth Location
Estimated Due Date
Do you have any special needs or circumstances you would like me to be aware of?
Total number of pregnancies, including this one?
Is/was there anything remarkable about your pregnancy/ies that you would like to discuss?
How did you hear about Birth Boot Camp?
***Referral Discount*** For every student you refer to this or a concurrent class series, 10% will be deducted from the cost of tuition for you AND your referral. Please list names of referrals here to receive discount. Referral discounts are available up to the date of your last scheduled class.
Do you have any additional questions?
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