Birth Boot Camp Class Registration Form

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Please complete this form and I will be in touch with you within 24 hours to complete the final steps of your registration. Thank you!

Class policies and FAQs: https://treasuredbirthservices.com/birth-boot-camp-classes/policies-faqs/

Hi there! I'm so excited to meet you. What's your name? *

Preferred Pronouns

What's your partner's name?

Preferred Pronouns

Email *

Address *

Phone Number *

How can I best contact you? *

Phone Call

Text Message

Other:

Required

How old are you? *

under 18

18-29

30-39

40-49

Congratulations on your pregnancy! When is your estimated due date? *

YYYY

How many kids do you have? *

Have you had a medicated birth?

Yes

Clear selection

Have you had a unmedicated birth?

Yes

Clear selection

Have you had a cesarean?

Yes

Clear selection

Have you had a VBAC?

Yes

Clear selection

Where are you planning to have your baby? *

Hospital

Birth Center

Home

Not Sure Yet!

Who is your care provider? *

Do you have a doula? If yes, what is their name? *

How do you feel about taking a childbirth class? *

How does your partner feel about taking a childbirth class?

Which class(es) would you like to register for? *

Birth Boot Camp Hospital Birth Class: 7-Week Complete Preparation for an Amazing Birth ($50 deposit required)

Out-of-Hospital (Home or Birth Center) 6-Week Birth Class ($50 deposit required)

Basic Training: 1-day Class ($50 deposit required)

Comfort Measures: Amazing Coping Strategies for Labor ($25 deposit required)

Hybrid Comprehensive 10-Week Class Series: Online + 1 In-person Class ($50 deposit required)

Newborn Care Class ($25 deposit required)

Sibling Class (must be paid in full before our class)

Required

Coupon Code?

Preferred Payment Method *

This is specifically for the deposit. You may pay the remaining balance with cash at the class, or the remainder of the amount via Paypal or Venmo before class begins.

Paypal

Venmo

Additional Information

Please tell me what you're most looking forward to about taking a Birth Boot Camp class, and anything specific you're hoping to learn. What are your goals for this birth? Anything else you would like me to know?

Photo Release *

By typing my name below, I grant to Hanan Webster of Treasured Birth Services the right to take photographs of me/us. I authorize her to use and publish the same in print and/or electronically. I agree that she may use such photographs of me/us, with or without my name, for any lawful purpose, including, for example, such purposes as publicity, illustration, advertising, and Web content.

How did you hear about my Birth Boot Camp classes? *

Referred by someone personally? Who can I thank?!

Submit

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