Lamaze registration form

Lamaze class registration

Please fill out the following form to register for class.
Full Name*

First NameLast Name
E-mail*
Phone Number*
Estimated due date*

MonthDayYear
Your registration includes one additional support person to attend the class with you. Will a support person be attending with you?*

YesNo
If yes, what is their name and relationship with you?
What are you hoping to gain or learn from taking this class?*
Do you have any food allergies/preferences?
Class information

WHEN: November 8th and 9th, 2025 9am-4pm each day

WHERE: Bismarck, ND

WHY: Lamaze childbirth education is based on the Lamaze Six Healthy Birth Practices which are based upon the most recent, evidence-based research. They are recommendations to help ease the birthing process and instill confidence. While some may have unique circumstances, all parents can benefit from understanding their options and having information available to them.

HOW: Class will be in a group format with up to five famliies and the instructor. Light refreshments will be provided during class, but feel free to bring your own meal or snacks if desired. Class will be relaxed and open for lots of discussion and questions. I want you to feel confident going into your birthing journey!
Class modification or rescheduling

If I am unable to host class due to illness, being a close contact for COVID-19, or am attending a birth, please be aware that I reserve the right to reschedule class to another day or host class online via Google Meet.

If you are ill and unable to attend class, class can be recorded and provided to you to watch on your own time. Or if you have been exposed to COVID-19 and are in quarantine, or even ill but well enough to listen to you class, you could join class live via Google Meet during our regularly scheduled class time. Please stay in communication with me regarding options so you can get all the information presented in class.
I may take photographs during class to use for marketing purposes. Please select one of options below.*

I consent to photography during class time and the photographs being used for marketing purposes.I DO NOT consent to photography during class time and the photographs being used for marketing purposes.
Disclosure

It is important to note that I am a mandated reporter by law and must report any suspected abuse or neglect of a child (born or unborn), elderly, or vulnerable person.
By signing this form, you are consenting to the conditions explained above with regards to participating in this class.*

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Pay later (CASH DISCOUNT) - If you plan on paying via check or cash, full payment must be received BEFORE the first class session. Please contact me to make arrangement for payment in person or via mail. Your spot for class will not be reserved until payment is received. Venmo is also available (@kathypaul1989)

Check or cash ($350)
Pay now - PayPal or credit/debit card
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Lamaze childbirth education
$360.00

Total

$0.00

Payment Methods

Debit or Credit Card

Choose from one of the PayPal options to make your payment.

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Lamaze class registration