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Register

Space for each course is limited - to reserve your space please submit the form below, and promptly send a cheque to:

Belly to Baby Prenatal Education
104 - 2000 Panorama Drive
Port Moody, BC V3H 5J5
Canada

Please note that the address above IS NOT the location for any courses.

Please see Weekend Group Prenatal Course Dates & Locations for location details. Please see the Prenatal Courses section of our site for course options and details.

Please include your name and course date with your cheque and make the cheque payable to either "Sarah Alexander" or "Belly to Baby". Your cheque will be cashed within one month of your course date. Please send your cheque in promptly to ensure reservation of your space.

Confirmation will be phoned or e-mailed to you upon receipt of your cheque. Receipts will be distributed at your scheduled weekend prenatal course.

*Required field.

*First Name:

*Last Name:

*E-mail:

Name of Your Birth Partner:

*Street Address:

*City:

*Province / State:

*Country:

*Postal / Zip Code:

*Tel:

- - ext.
area code

Alternate Tel:

- - ext.
area code

Fax:

- - ext.
area code

*Due Date:

- -

*Planned Birth Location:

name of hospital or other location

*Course You'd Like to Attend:

	Private Prenatal Class (4 Hours)	$320*
	Private Prenatal + Newborn Class (6 Hours)	$480*
	Private Post-Childbirth Debriefing (2 Hours)	$210*
	Refresher Course (3 Hours)	$80
*+ $0.45/km

Weekend Group Prenatal Course
	††May 29 / 30, 2010	$250
	June 26 / 27, 2010	$250
	August 7 / 8, 2010	$250
	September 11 / 12, 2010	$250
	October 16 / 17, 2010	$250
	November 20 / 21, 2010	$250
	Future Date	$250
††New date (changed from original May 22 / 23, 2010) ** Indicates class is full (please contact us for waitlist information).

Other Services
	Obstetrical Tens Machine Rental (31 days; $15 each add'l week + $50 damage deposit)	$110
	RN Doula Service (contact regarding rate / availability)

*Name of Physician / Midwife:

*Medical Issues Related to Your Pregnancy:

How Did You Hear About Us?

other

Promo Code:

Comments or Questions?

*Are you human?

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Cancellation Policy

YOUR DEPOSIT IS NON REFUNDABLE. In the event you have delivered your baby on or before the date you have registered for your course, your deposit will gladly be refunded, less a $25.00 administration fee.

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