HypnoBirthing Enrolment Form

HypnoBirthing Class Series Sign-up

Please fill out the form below and select the class you'd like to take. Payment instructions are at the bottom.
Tell me about yourself?
Full Name*

First NameLast Name
Due Date*

MonthDayYear
Date
Mother's Date of Birth*

MonthDayYear
Partner/support person name

First NameLast Name
Address*

Street Address

Street Address Line 2

CityRegion

Post CodeCountry
Mobile Number*
Email Address*
Place of Birth*
Please list Home, Birth Center, Hospital - List the name as well. For example: St. Joes
Doctor or Midwife*
Please list Doctor or Midwife's name or the practice
This is my:

First babySecond babyThird babyFourth +
Anything we should know about you? *
About your pregnancy? A fun fact? Anything!
Course Sign-up
Course Date to enrol (please choose ONE)*

Zoom Thursday November 7th, 14th, 21st, *skip 28th*, December 5th, 12th - 6:30 - 9pmSunday - November 10th, 17th, *skip 24th*, December 1st, 8th, 15th - 12pm - 2:30pmSaturday - January 4th, 11th, 18th, 23rd, February 1st - 10:30 -1pmThursday - VIRTUAL - January 16th, 23rd, 30th, February 6th and 13th - 6:30 - 9pmSunday January 19th, 26th, February 2nd, 9th and 16th. - 12pm - 2:30pmSaturday, February 22nd, March 1st, 8th, 15th & 22nd - 10:30 -1pmTuesday - VIRTUAL - March 11th, 18th, (Skip 23rd), April 1st, 8th, 15th - 6:30pm - 9pmSunday, March 30th, April 6th, 13th, (skip 20th), 27th, May 4th - 1-3:30pmSaturday, April 26th, May 3rd, 10th, 17th, 24th - 10:30am - 1pmPrivate Class - In Person ($450)Private Class- Virtual Private ($375)Other
How did you find us?*
I understand that the class costs $330 (this includes the book, handbook and download card or code.) Denver Birth and Wellness (She Believed Birth Services, LLC) reserves the right to cancel, move, reschedule, or change the time, of a class or class series or end class early. (Although not common). This charge in non-refundable. By signing-up and pay the fee, I am therefore saving a spot for you and turning someone else away. So to state again, NO REFUNDS on the $330 fee. Books will distributed during class one or two (sometimes class 3 if Virtual Class due to shipping as I wait until the first class to send out to make sure everyone is committed to class... books and handbooks are pricey). Thank you! We will have fun!!! I can confirm I have read and accept all the terms and conditions of enrolment set out within this form:*

Yes
Payment

Let me get to know you! Please fill out this questionnaire. I will contact you just prior to the class. You can pay on the website, www.shebelievedbirth.com, click 'HypnoBirthing Classes' than all the way at the bottom you will see a "pay" button. Hit that and you can pay. If you want to use an FSA/HSA please email me at: denverbirth@gmail.com or call/text 970-302-6359. The course needs to be paid in full one week before the first day of class. Feel free to talk to me about a payment plan if needed.
Should be Empty:

HypnoBirthing Class Series Sign-up

Tell me about yourself?

Course Sign-up

Payment