Group Class Registration Sheet
Please complete this form to register for Group Childbirth and / or Breastfeeding & Newborn Care Classes!
Partner or Support Person's name:
Your prenatal provider:
Olympia Obstetrics & Gynecology
Olympia Women's Health (Dr. Moruzzi)
Providence Family Medicine
Around the Circle Midwifery
South Sound Women's Center
Madigan Army Medical Center OBGYN / Midwifery
Franciscan Women's Health
Your estimated due date:
Have you given birth previously?
Yes, I have an older child (or children).
No, this is my first child.
Please complete the following to register for Childbirth Education Class
Please select a class:
Cost: $140 for four week series on Tuesdays from 6 - 8pm at Olympia Obstetrics OR $120 for a one day class on Saturday from 9:30am - 4:30pm. *Classes include an optional tour of St Peter's Family Birth Center*
Four Week Series, January 28th - February 18th, 2020
One Day Class, March 28th, 2020
Four Week Series, April 14th - May 5th, 2020
One Day Class, June 6th, 2020
Four Week Series, July 28th - August 18th, 2020
One Day Class, September 26th, 2020
Four Week Series, October 13th - November 3rd, 2020
One Day Class, December 5th, 2020
What is important for you to learn from this class?
Do you have any special circumstances you'd like me to be aware of? (multiples, high risk pregnancy...)
Please complete the following to register for Breastfeeding & Newborn Care
Please select a class:
Cost: $30 for 1 evening class, select Tuesdays from 6 - 8:40pm at Olympia Obstetrics. ($20 if taken along with a childbirth education class or series.)
Breastfeeding Class, February 25th, 2020
Breastfeeding Class, May 12th, 2020
Breastfeeding Class, August 25th, 2020
Breastfeeding Class, November 10th, 2020
What is important for you to learn about breastfeeding & newborn care?
If payment is an issue, please let me know in the comments section, payment plans, sliding scales, or scholarships may be available on a case by case scenario.
Your payment method:
Check. (Please make checks payable to Stefanie Anderson or Foveo Birth and mail to 2528 10th Ct SE Olympia, WA 98501.)
Cash. (I will contact you to make payment arrangements, please do not mail cash.)
Credit Card or PayPal. (Please click the payment link provided after you submit this form.)
Other. (Please provide information in the comments section.)
Cancellation / No Show / Refund Policy
CANCELLATION / NO SHOW / REFUND POLICY --- If you've registered and paid for classes and are unable to attend, the instructor will refund your registration less a $10 processing fee. Cancellations must be received at least one week prior to the first day of class in order to be eligible for a refund. Please allow up to two weeks for your refund to be processed. If you cancel less than one week prior to the first day of class you are not eligible for a refund. If you "no-show" for a class you've registered for and have not given prior notice to the instructor you will be responsible for the full class fee. In the rare case of inclement weather, or instructor emergency or illness when a substitute is not available, classes may be cancelled. Every effort will be made to provide as much notice as possible and to schedule a make up class as soon as possible. In cases where a make up class is not possible, a partial or full refund may be available.
Finally, how did you hear about Foveo Birth & Baby classes?
Family / Friend Referral
Provider Referral (Olympia OBGYN)
Provider Referral (Other Provider)
Flyer or Business Card
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