Register for Sue's Class
Class Start Date:
July 15 - Sept 23
Sept 10 - Nov 26
Nov 4 - Feb 5
Expected Due Date:
Full Name:
Coach's Name:
Email Address:
Daytime Phone:
Evening Phone:
Address:
Name of Doctor / Midwife:
Do you have other children?
Yes
No
If so, what are their ages?
How did you hear about us?
Friend/Family - Please specify
Doctor / Midwife - Please specify
From Here Through Maternity Booklet
The Business of Being Born Movie Screening
Internet Search
Bradley Method Website
Other Advertisement - please specify
Details:
What will your baby's last name be?
Additional Comments / Questions?
Anything you'd like me to know?
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Healthy Birth Choices