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)*

Saturday, September 20th, 27th, October 4th, 11th, 18th - 10:30am - 1pmSunday, October 12th, 19th, 26th, November 2nd, 9th - 1pm - 3:30pmSaturday, November 8th, 15th, 22nd, *skip 29th*, December 6th, 13th - 10:30am - 1:00pmSunday, November 23rd, 30th, December 7th, 14th 21st - 1pm - 3:30pmPrivate Class - In Person ($450)Private Class- Virtual Private ($375)I'm interested in a Virtual ClassOther
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 is non-refundable. By signing up and paying the fee, I am, in effect, saving a spot for you and turning someone else away. To reiterate, there are no refunds on the $330 fee. Books will be 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.denverbirthandwellness.com, click 'HypnoBirthing Classes', then 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.
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HypnoBirthing Class Series Sign-up

Tell me about yourself?

Course Sign-up

Payment