5 Week Childbirth Class Series sign-up

5 Week Childbirth Class Series sign-up

Online through Zoom
Pregnant persons name

First Name Last Name
Partners name

First Name Last Name
Due date
Planned place of birth
Email
example@example.com
Phone Number

Area Code Phone Number
Mailing Address for sending supplies

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
You have two options for payment to choose from.

Either payment through PayPal which has an additional fee,

OR

You can pay through Venmo to @Angie-Hotz

If you choose PayPal, follow the directions below. If you choose Venmo, pay the $200 fee right after filling out this form. **Note, there is no additional fee to use Venmo**
Click here if you will be sending a Venmo Payment

Venmo for 5 week childbirth class series
Click here for Paypal Payment (note the additional fee for PayPal)
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5 week childbirth class series $ 210.00

Total $ 0.00
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