Expecting Your Miracle
Oct 28, Nov 4, 11, 18, 25 & Dec 2,9: 6pm-8pm
Mother's Name
*
First Name
Last Name
Will anyone be attending class with you? We strongly encourage a support person attend so that everyone feels prepared. No need to create another registration.
First Name
Last Name
How old are you?
Pregnant person's age
Estimated Due Date 00/00/00
*
Where do you intend to deliver?
Please enter name of Hospital or Birth Center . If you are planning a home birth, please write Home.
Email
*
example@example.com
Phone Number (for class communications)
*
Please enter a valid phone number.
Format: (000) 000-0000.
Permission to send reminder texts?
*
Yes
No
City in which you reside
*
Which of the following best describes you?
Asian or Pacific Islander
Black or African American
Native American of Alaskan Native
White or Caucasian
Multiracial or Biracial
An ethnicity no listed here
How did you hear about us?
PRC Staff/Nurse
Doctor/Midwife
Friend/Family
Social Services (DSHS, WIC...)
Online Search
Other
Submit
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