Apply to join an upcoming childbirth class Application Childbirth Classes Do you want to sign up for:* Weekend Immersion or 6 Week Childbirth Class Birthing Again One Day Workshop Select your class date and location* SOLD OUT! February 22 and 23 (you can fill out the form to be added to the waitlist) Birthing Again--Feb. 26th and March 4th, Wednesdays 6:30-9pm Childbirth Immersion--March 21 and 22, Saturday & Sunday, 10-6pm Birthing Again--April 25th Saturday 12:30-5:30pm Childbirth Immersion--May 16 and 17, Saturday & Sunday, 10-6pm Childbirth Immersion--August 29 and 30, Saturday & Sunday, 10-6pm Don't see your preferred class dates listed? That means it is full. Please email me to join the waitlist. Birthing Person's Name* First Last Birthing Person's Email* Birthing Person's Pronoun-(She, He, They or ?)Partner's Name First Last Partner's Email Partner's Pronoun (She, He, They or ?)Partner's Relationship to Birthing PersonFull Mailing AddressBirthing Person's PhonePartner's Phone:Estimated Due DateDo you want to join my quarterly mailing list?* Yes No May I share your email with your classmates? Yes No Maybe Do you have other children? Yes No One of us does If yes, what are their names and ages?Intended birth location(Cedars, Kaiser, Home, Del Mar Birth Center, etc...)Who is your OB or Midwife?Have you already or do you plan to hire a doula? Yes No Maybe Doula's NameHow did you hear of these classes?What have you already been doing to prepare for labor and birth (classes you've taken, books you've read, etc.)?When you imagine the intense moments of labor, what do you imagine will help/support you most?What concerns do you have about labor, birth and new parenthood?What are you looking to get out of our time together?Anything else I should know about you, your partner, pregnancy, or journey to birth and parenthood (medical conditions, special situations, new to the area, etc.)?Do you prefer to pay a deposit or the full amount at this time to confirm your registration??* Immersion full amount $650 Immersion Deposit/Birthing Again Full $450 Enrollment Terms and Conditions: 1) Non-refundable deposit. Deposits hold your space just for you! They are non-refundable except in the case of medical emergency or early arrival of your baby. 2) Balance is due prior to the beginning of the first class. No refunds are given after start of class. 3) No prorating will be offered for missed classes due to work, scheduling conflicts, travel, or early arrival of your baby. If you or your partner are unable to attend any portion of the scheduled class time, attempts will be made to help fill in the missed content, but classes are richly experiential and it is impossible to convey the complexity of topics, content, dialogue, group engagement, and practice covered in each class. It is best to attend every class whenever possible. 4) Classes start on time. Please make arrangements to arrive to each class on time to minimize missed information and class disruption. 5) Schedule changes. Sometimes unexpected events occur (just like in birth!) and classes have to be changed. When this happens, we do our best to accommodate everyone's needs. If a schedule change means you can no longer attend the series/immersion, then it is often possible to switch to a different series/immersion. If this is not possible, a refund can be issued. 6) Class cancellations. A minimum of three mothers/couples are required for a class to run. If a class is cancelled due to low enrollment, you will be offered a different class or the option of a refund. 7) Waiver. A waiver of liability is required from each class participant and will be given at start of first class. If you would like to see the waiver before then, please contact us for a copy. Do you agree to the above terms & conditions?* Yes No Once accepted you will receive an invoice and all the details for your childbirth class.NameThis field is for validation purposes and should be left unchanged. This iframe contains the logic required to handle Ajax powered Gravity Forms.
