Birthing Center Class Registration Form

To register for any of the Birthing Center's classes, select the desired class (listed by the first session, if it is a series) and provide your contact information.  Note that the time of the classes change with the 2008 series.
 
Prepared Childbirth (5-week series)

January 15, 2008
February 9, 2008 (New One-Day Class)
March 4, 2008
April 19, 2008 (New One-Day Class)
May 6, 2008
June 21, 2008 (New One-Day Class)
July 15, 2008
August 9, 2008 (New One-Day Class)
September 9, 2008
October 25, 2008 (New One-Day Class)
November 4, 2008

 

I wish to enroll in the following Prepared Childbirth class
(enter the starting date from list above)

 

Sibling Class
January 14, 2008
March 3, 2008
May 5, 2008
July 14, 2008
September 8, 2008
November 3, 2008

I wish to enroll my child(ren) in the following Sibling Class
(enter the date from above)

Names of children you are enrolling:
Child 1: age
Child 2: age
Child 3: age

 

Cesarean Section
Please contact me about arranging for a Cesarean Section class

Contact Information
Name:               
Street Address
City:                  
State:                
Zip:                   
Telephone:      
Email Address:
Due Date:        
Obstetrician/Midwife: