Pregnant Student Class Enrollment Form

Pregnant Student Class Enrollment Form

Pregnant Student only, fill out, sign and date please
Instructor and Class Date Information:
HYPNOBABIES INSTRUCTOR'S FULL NAME (NOT *your* name!)

First NameLast Name
Hypnobabies Instructor’s EMAIL ADDRESS:
example@example.com
Hypnobabies Instructor's Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Hypnobabies Class Start Date:

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Will you be attending a 1) Group Hypnobabies Class Series, or 2) Private Hypnobabies Class Series, or 3) Home Study Advantage Class (only for Hypnobabies Self-Study students)?
Pregnant Student & Birth Partner Information:
PREGNANT STUDENT'S FULL NAME:

First NameLast Name
Pregnant Student's Email Address:
example@example.com
Pregnant Student’s Mobile #:
Please enter a valid phone number.Format: (000) 000-0000.
Pregnant Student's Mailing Address

Street Address

Street Address Line 2

CityState

Zip CodeCountry
Estimated Due Date:

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
This is my first baby
Did you have a phone conversation with your Hypnobabies Instructor?
YOUR BIRTH PARTNER'S FULL NAME:

First NameLast Name
Birth Partner's Email Address:
example@example.com
Birth Partner’s Mobile #:
Please enter a valid phone number.Format: (000) 000-0000.
I am/we are planning a:

Other
I am planning a VBAC! 💕
Planned Birth Location

Street Address

Street Address Line 2

CityState

Zip CodeCountry
Any concerns or fears about this pregnancy/birth?
What I would like to learn in this course is:
Would you feel comfortable sharing your previous birthing experience(s), if applicable?
🤩 VERY IMPORTANT - Please make sure your Birth Partner completes their own Hypnobabies Class Enrollment Form so you can receive your Pre-Class Hypnosis Tracks! Link below for your convenience.
🤩 Click here for the Birth Partner's Hypnobabies Class Enrollment Form and make sure they complete it ASAP so you can receive your Pre-Class Hypnosis Tracks!
Hypnobabies Hypnobirthing Class Enrollment Agreement:
By signing below I, {pregnantStudents11}, declare that I have read ALL of the information on the Hypnobabies Class Enrollment Information page at Hypnobabies Class Enrollment Info and I understand and agree with all of the information on that page, before enrolling in this Hypnobabies Hypnobirthing class.
Name of Pregnant Student

First NameLast Name
Pregnant Student Signature
Date of Signature

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
We'd love to know where you found your Hypnobabies Class!
Should be Empty:

Pregnant Student Class Enrollment Form

Instructor and Class Date Information:

Pregnant Student & Birth Partner Information:

Hypnobabies Hypnobirthing Class Enrollment Agreement: