Ypsi-Arbor Childbirth Education Class Registration
Name *
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Phone *
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Email address *
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Partner name
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Partner email address
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Partner phone
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Estimated due date *
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DD
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Home address *
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Birthing location & care providers
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How did you hear about us? *
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Anything you think would be helpful for us to know before class starts? Care providers, pregnancy history, birth preferences, etc...
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Class type *
May we contact you regarding future events and information?
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