Register for HypnoBirthing
Childbirth Education Classes

This page contains the form needed to register your details for attending HypnoBirthing Childbirth Education Classes. It is not actually an enrollment page, but simply provides me with the information needed to send you out an information pack by mail tailored to your requirements, and to keep track of how many places are left in each group class.

You can return your enrollment form with your deposit when you're ready to enroll in the next class.

HypnoBirthing Small Group Classes are held at either our Northside or Southside venues depending upon the date you choose.

HypnoBirthing Private Classes - are held at your choice of either our Northside or Southside venues, or your own home starting on a date that is mutually convenient.

Please check the venue details on the HypnoBirthing Classes page for more information.



HypnoBirth Classes Registration Form
Please note that all fields followed by an asterisk must be filled in.
First Name*
Last Name*
E-mail Address*
Street Address*
City*
State/Prov*
Zip/Postal Code*
Home Phone*
Birth Partner's First Name*
Birth Partner's Surname
Baby is due... (just the month, not date)*
Select Your Preferred Session*
I agree to pay by...*
Direct Bank Deposit (details will be provided with your enrollment form)
PayPal (a PayPal invoice will be emailed to you)
Payment Plan $100 deposit to secure your place and the balance paid as arranged with CNB staff.
Please indicate how you found us.*
If you were referred by a friend, could I please have their name to thank them?

Please enter the word that you see below.

  


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Canberra Natural Birth
HypnoBirthing in Canberra ACT and Queanbeyan NSW


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