refresher class registration form refresher class registration form Please choose which class you are registering for: * Private class, time, date, location TBA $250 Sunday, Feb 18th, 11-4:30, Del Mar Birth Center $150 Mom's Name: * Partner's Name: Partner's Relationship to Mom: Estimated Due Date: * Address: * Phone Number: * Alternate Phone Number: Mom's Email: * Partners's Email: * OB/Midwife's Name: * Place Planned for Delivery: * Who is your doula if you are working with a doula? How did you hear about the class? * Names and ages of your children: * Are you planning a VBAC (Vaginal Birth after Cesarean) * Yes No What were your main take aways from your previous birth experience(s)? * Describe any medical conditions we should be aware of: What is mom's greatest concern with pregnancy, labor, birth or postpartum? * What is partner's greatest concern with pregnancy, labor, birth or postpartum? * What do you hope to gain from this class? * I have read and agree to the Terms & Conditions. * I agree Review the Terms & Conditions here. You will not be registered for your class until you have paid. Please pay via PayPal below or if you would prefer to mail in a check, please contact firstname.lastname@example.org to receive further instructions. Class Registration Options Public class $150.00 USD Private class $250.00 USD Join the Community Community is a vital part of wellness for new and expecting families. Sign up for our newsletter to receive a monthly message from us with upcoming events. Join Welcome to the Two Doulas Birth Community.