Class Registration: Breastfeeding

Breastfeeding Class Registration

Thank you for your interest in the Breastfeeding class. To register for the class, please fill out the information below. Once we have received your registration information, you will be emailed an invoice for the class tuition.

Mother's Name:

First NameLast Name

Father's Name:

First NameLast Name

Due Date:

MonthDayYear

Mother's Cell Phone:

Area CodePhone Number

Father's Cell Phone:

Area CodePhone Number

Mother's Email Address:

Father's Email Address:

Please register me and my partner for the next available class:

I understand that, to complete my registration and guarantee a spot in the Breastfeeding & Postpartum Workshop, the class tuition must be paid no later than 7 days after submission of this registration. If the tuition is not paid within 7 days, I understand that I will forfeit my spot in the class.

*Please note that you will receive an invoice via email for the class tuition. This invoice will have payment information located at the bottom.

Agreement: