Name * First Name Last Name Email * Phone (###) ### #### Due Date MM DD YYYY Name of guest attending the class with you (if applicable) What class are you signing up for? * One Day Class $200: January 25 9:30am-4:30pm 4 Week Class $250: Every Thursday in February (6, 13, 20, 27) 6-9pm Payment Options (due first day of class) * Venmo (@haileydoulaservices) Cash or check Do you consent to have your pictures taken? I will ask for permission prior to posting online. * Pictures are ok No pictures please How did you hear about my class? Thank you! Childbirth Class Registration