Hypnobirthing Australia Classes
Please fill out the form below to enrol in one of my classes. If you have any questions feel free to contact me via email or phone.
hypnobirthingmacarthur@gmail.com
Christa - 0422 229 312
Email address *
Course Enrolment
Mother's Name *
Your answer
Mailing Address *
Your answer
Preferred Phone *
Your answer
I wish to enrol in a: *
Please select the group course date you wish to attend or select 'other' if booking a private session(s) with me: *
Estimated Due Date (EDD) *
MM
/
DD
/
YYYY
Birth Companion Name *
Your answer
Relationship to you (e.g. spouse, partner, doula etc.) *
Your answer
Intended place of birth (name of hospital, birth centre or home)
Your answer
Care Provider Name and Title (e.g. Obstetrician or Midwife)
Your answer
Is this your 1st, 2nd, 3rd etc. baby? *
Your answer
Is this birth a VBAC (Vaginal Birth After Caesarean)? *
I teach group classes in my home. In order to ensure that I can provide a safe and comfortable environment for all please let me know if you have any dietary requirements, allergies or other needs.
Your answer
Is there any important information you wish me to be aware of before classes commence?
Your answer
How did you find out about my classes? *
Required
Tuition Fee: $550 Group classes
Fee includes your Hypnobirthing Australia folio and 2 x Australian Practice albums.
Payment plan available for clients with limited income.
To hold your place please submit this form with a $150 non-refundable tuition deposit.
Final payment is due 7 days prior to course start date.
***Please note: Cancellations/refunds cannot be accepted within 7 days of the course start date. At this time, refund (of the $400 balance) can only be given in exceptional circumstances.***

Bold Beautiful Birth Antenatal Support Package ($997) must be paid in full on booking OR payment plan (3 x monthly payments of $397 - you will receive instant access after the first payment). Payment links below.
This package includes:
- Hypnobirthing Australia group course PLUS
- 8 online modules
- 8 workbooks
- weekly group calls throughout your entire pregnancy
- 2 x private coaching calls
This package provides the ultimate combination of hypnobirthing and doula support during your pregnancy!

Payment can be made via PayPal (preferred) or direct deposit.
If you are paying in two payments (deposit and balance), PayPal is my preferred payment method. Please pay via this link:
https://www.paypal.me/ChristaBuckland

OR

Direct Deposit Details:
Bank: ANZ
BSB: 012-556
A/C: 587550123
Name: Christa Buckland

If you are paying in full (for the group course), please pay via this link: https://www.boldbeautifulbirth.com/offers/3abtVivT

If you are paying in full (for Bold Beautiful Birth Antenatal Support Package), please pay via this link: https://www.boldbeautifulbirth.com/offers/E26Nt5eu

If you are choosing the payment plan (for Bold Beautiful Birth Antenatal Support Package), please pay via this link: https://www.boldbeautifulbirth.com/offers/qGhuF4PH

A copy of your responses will be emailed to the address you provided.
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