Private Birth Class Pre-Registration
Give us as much information as you feel comfortable to help us customize the perfect private class for you.
Primary Parent (the parent to contact)
Your answer
Primary Parent Email Address
Your answer
Primary Parent Phone Number
Your answer
Primary Parent Occupation
Your answer
Partner's Name
Your answer
Partner's Occupation
Your answer
Mailing Address (street, city, zip)
Your answer
Baby's Name (optional)
Your answer
Gender of Baby
Due Date
MM
/
DD
/
YYYY
Name of Obstetrician or Midwife
Your answer
What number baby?
Your answer
Place of Birth (name of Hospital, Birth Center, Home):
Your answer
Which class are you interested in?
Which class are you interested in?
Which days of the week are best for your private class?
Required
What time of day is best for your private class?
Required
Tell us about yourself, what is important to you, and your journey to this point:
Your answer
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