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	Country

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 work best for you. This will help me plan upcoming classes based on the preferences of the majority of attendees. Please check all that apply to maximize options.

Monday to Friday - daytime Monday to Friday - evening Weekend - daytime Weekend - evening
This class usually takes place over 6 weeks, however, some attendees may prefer an expedited class due to a fast approaching due date and/ or other scheduling limitations. Please let me know your preference in this regard:

I would prefer the 6 week option- beginning April 29, 2020 I would prefer the 6 week option- beginning May 14th, 2020 I would prefer the 6 week option- beginning June 9th, 2020 I would prefer an expedited 3 week option- which would mean having 2 zoom classes per week (not dates set at this time but if there is interest I can arrange it) I would prefer a class starting in July I would prefer a class starting in September I would prefer a class starting in October
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! Once I have confirmed dates/ times for your sessions, I'll send you a link to begin your EBB® "orientation", to watch 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