EBB® Childbirth Class Registration

EBB® Childbirth Class Registration Form

Thank you for your interest in our Evidence Based Birth Childbirth Class- I'm looking forward to connecting! Please fill out this short form so that we can get started!
Name of Birthing Person

First Name Last Name
Estimated Due Date

Month Day Year
E-mail
Phone Number

Area Code Phone Number
Address

Street Address

Street Address Line 2

City Province

Postal Code
Partner/ Birth Partner's Name

First Name Last Name
Phone Number

Area Code Phone Number
Email
example@example.com
General Information

Classes consist of max 6 couples. These questions will help me to accommodate schedules as best I can!
Please indicate below if you have particular times or days of the week that typically work best for you. Please check all that apply to maximize options.

Monday to Friday - daytime Monday to Friday - evening Weekend - daytime Weekend - evening
This class takes place over 6 weeks. Please let me know which start date works best for you:

Tues, September 8/20 @ 6:30pm Tues, October 20/20 @ 6:30pm Thurs, November 26/20 (Accelerated 3 week class held on Thursdays & Mondays) Thurs, Jan 7/21 @ 6:30 Tues, Feb 16/21 @ 6:30 Thurs, April 1/21 @ 6:30 Tues, May 11/21 @ 6:30
Is there anything else you'd like me to know about you before we get started? Any particular questions or concerns?
I will be in touch shortly! I'll send you a link to begin your EBB® "orientation" videos in advance of our first class. Should you have any questions, please contact Wanda at wandacox@eastlink.ca

Warmly, Wanda Cox

www.gracefulbeginnings.ca
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EBB® Childbirth Class Registration Form

General Information