Registration Form for Birth Boot Camp Out Of Hospital Mini Series (4 weeks)
Welcome! In an effort to use less paper and save time in class, I have created this google form for registration and introduction.
Payment: Half of the cost of the series is due upon registration. So within 3 days I will email you a PayPal invoice where you can pay using paypal or a credit/debit card. If you prefer a different form of payment, please email me. The remaining balance will be due at the beginning of the first class.

*Please Note: Unless taking a private class in your home, the location of the group class is at Katie's home in Catonsville, MD near Woodbridge Elementary School (exact address will be a part of the welcome email coming shortly). I take every consideration possible for your comfort and needs and will address any specific requests you have. We do have a cat in our home; however, she will be kept in another room during class. I will clean as best I can before each class. If you are severely allergic to cats, please contact me directly. I may be able to utilize a back up location, refer you to another BBC instructor or offer you a private class.

Thank you!
Katie Tighe, Doula, BBCI, SpBPPE
Warmscarfdoula@gmail.com
864.356.3487

Please select which class you wish to register for: *
Mom's Name *
Your answer
Partner's Name
Your answer
Address *
Your answer
Email (For: welcome email, paypal invoice, follow up emails and other important communications. NOT for newsletter unless otherwise given permission.) *
Your answer
Do you want to join the Warm Scarf Doula newsletter email list? *
Partner's Email (If he/she would like their own copy of the weekly emails with reminders and follow up info)
Your answer
Cell Phone Number *
Your answer
Age
Your answer
Estimate Due Date *
MM
/
DD
/
YYYY
No. of Children
Your answer
No. of Medicated Births
Your answer
No. of Unmedicated Births
Your answer
No. of Cesarean Births and if applicable, VBACs
Your answer
Where are you planning to have your baby? *
Your answer
Who is your care provider? (Name and Profession: Dr., CNM, CPM, None?)
Your answer
How do you feel about taking childbirth classes?
Your answer
How does your partner feel about childbirth classes?
Your answer
Do you or your partner have any highly sensitive food allergies, such as nuts? Good to know for snack breaks. *
Your answer
Do you have any special accommodations or requests for yourself or your partner during class? Or Additional Notes for Instructor:
Your answer
Coupon/ Promo Code? (Limited Availability, MUST present physical flyer or coupon to Instructor at the first class.)
Your answer
How did you hear about this particular Birth Boot Camp series with Katie Tighe? *
Required
Thank you!
Check your email over the next few days, I will email you an invoice as soon as possible and a welcome email. A release of liability form will also be in the first email for your review. Please contact me if you have any questions.
I look forward to working with you for the 10 week series! -Katie Tighe, BBCI
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