Comfort Measures & Labor Positions registration form

Comfort Measures & Labor Positions 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: Sunday August 3rd, 2025 1-5pm

WHERE: Bismarck, ND

WHY: This class will teach you all the ways to cope with the intensity of labor, and practice different positions you can use during your birthing time and pushing stage. This is a great option if you have are having a baby SOON and need a crash course on how to get through labor without the use of medication. Or maybe you have taken a full childbirth ed class in the past and just need a quick afternoon refresher course. The cost of class includes the pregnant woman and one support person.

HOW: Class will be in a group format with other expecting families. 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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If you plan on paying via check or cash, full payment must be received BEFORE the class. 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.

Doula client discount rate - Check or cash $100Doula client discount rate - Venmo $100 - @kathypaul1989 (must choose "family and friends)Full rate - Check or cash $125Full rate - Venmo $125 - @kathypaul1989 (must choose "family and friends)
Pay now - PayPal or credit/debit card ($10 service fee added for PayPal/card)
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Doula client discount rate for Labor positions and comfort measures class
$110.00 Quantity

Full rate for Labor positions and comfort measures class
$135.00 Quantity

Total

$0.00

Payment Methods

Debit or Credit Card

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

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Comfort Measures & Labor Positions Class registration