Please fill out the form below. Once received a confirmation email will be sent within 48hrs. Those wishing to make payment online can do so for a small additional processing fee.   If you choose not to use this service I will provide you with the address as to where to send your deposit.  You are "officialy" registered once deposit is processed.

* Required fields

Name *

E-mail Address *

Partners Name

Phone Number *

Mailing Address

City/Town

Postal code

Due Date *

Select Class Series * Sept. 13 - Nov. 8 Oct. 19 - Jan. 11 Dec. 13 - Mar. 6 Other

First Baby Yes No

Name of Doctor or Midwive

How you heard about us?

Any Addition Questions or Comments

Online Payment

Payment Options Deposit+ Processing Fee= $52 Deposit+ Payment+ Processing Fee= $407 Payment+ Processing Fee= $355

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Name on Credit Card & Mailing Address if different then above

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Expiry Date

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