Registration

Thank you for choosing Creating Your Calm for your child birth course and/or Doula services! If you have any problems or questions while filling out the registration form please contact Elizabeth directly at elizabeth@creatingyourcalm or 919.721.2693.

Child birth education families: A non-refundable deposit of $100.00 is required to reserve your seat for this course. The remaining balance is due before the beginning of the first course. You may pay in full at any time. If you are paying the remaining balance at the start of the first class, please plan to arrive 10 minutes early for processing.

Doula families: A non-refundable deposit is due to secure Doula services for your "birth month". The remaining balance must be paid before I can go on call (your 38th week). You may pay in full at any time.
I am so excited for you to experience this amazing transformation!

Mother's First Name *

Mother's Middle Initial

Mother's Last Name *

Street Address *

Street Address 2 *

City, State, Zip *

Phone Number *

Cell Phone Number

Email Address *

Which class have you chosen to attend?

Will you be utilizing Creating Your Calm for Doula support?

Yes

Unsure at this moment

When Is The Epected Arrival of Baby? *

Birth Companion's First and Last Name (Spouse, Partner, Relative, Friend etc.)

Birth Assistant's First and Last Name (Doula, Friend, Relative etc.)

Name of Care Provider *

Chosen Place of Delivery *

Please share with us anything else you feel we should know. Privacy is highly respected.

How Did You Hear About Creating Your Calm?

I Understand that my seat in the course will not be reserved until my 100.00 non-refundable class deposit is paid and that payment in full is due before first class *

I Agree

Please follow this link for payment options

Recent Posts

Categories

Archives

Meta