Required fields are marked with asterisks (*)

Birthing Class Registration

Please fill out the information below. Questions marked with a * are required.

Your first and last name:

Your date of birth:

Partner's name:

Address:

Street name/number:

City/town:

Province:

Postal Code:

Email address:

Phone number (day):

Phone number (evening)

Cell phone number:

Your OBGYN doctor or midwife's name:

Your due date:

Which day of the week would you prefer your class?

A new weekend fast track class is now available. Please provide your 1st and 2nd choice:

Would you like to register for our Prenatal Breastfeeding Class?

Yes

**Please do not issue payments until AFTER receiving a confirmation email from us.