The Birth Class with Illuminatal Doula Services
Please complete the information below to register for The Birth Class. Deposit is due at the time of registration to secure your spot.
Which Birth Class are you registering for?
January 8-9 - Heights
April 2-3 - Heights
Other
Full Name
*
First Name
Last Name
Spouse/Partner Name
*
First Name
Last Name
Relationship Status
*
Married
Common Law / Partnered
Separated
Divorced
Other
None
Home Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
*
-
Area Code
Phone Number
E-mail
*
Due Date
*
Baby's Gender
*
Boy
Girl
Surprise
Where are you planning to give birth?
*
Who is your care provider for this birth?
*
Who referred you to The Birth Class?
*
We cover a wide variety of topics in our class. What 3 topics are you most interested in?
*
prenatal preparation for birth
normal labor progression / how birth works
coping techniques and comfort measures
medical options for pain relief
common medical interventions
alternatives to medical interventions
positions for labor and pushing
procedures for baby after birth
the amazing placenta and its benefits
recovery and postpartum
newborn care
breastfeeding
vaccinations
circumcision
Additional Comments or Requests
Class Payment - Payment screen will open after form submission.
*
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The Birth Class - Full Payment
$
250.00
The Birth Class - 50% Deposit - Remainder Due at First Class
$
125.00
Pre-paid with doula services
$
Free
Enter coupon
Apply
Total
$
0.00
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