Two Rivers Childbirth: Group Childbirth Education Registration

Please fill out the form below to register for any scheduled group class. We're so excited to get to know you!

Class Date and Location *

Please include the date and location for group classes.
Names of attendees *
Your Email Address *
Best Phone Number to Reach You * - ### - ### ####
Your Address *
Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country
Preferred Method of Contact *
Estimated Due Date * / MM / DD YYYY
Name of your Midwife or OB *
Previous Birth Experinces

If you have older children please tell me a little about their births.
Class Expectations

What do you hope to gain from this class, or what would you most like to see covered?
Tidbits About You!

Tell me a little something about you! Please include any accommodations you may need for class.
Any dietary restrictions?
Limits and Exceptions

- This registration includes space and materials for two attendees only
- Class dates and times are already scheduled and cannot be changed
- If you miss a scheduled class for any reason we may be able to accommodate a make-up class but are not required to do so and are not required to issue a refund for missed classes.