Class Registration Name* First Last Email* Phone*Address* Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanÅland IslandsAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarrussalamBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCook IslandsCosta RicaCôte d'IvoireCroatiaCubaCuraçaoCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatini (Swaziland)EthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacauMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth KoreaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRéunionRomaniaRussiaRwandaSaint BarthélemySaint HelenaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth GeorgiaSouth KoreaSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan Mayen IslandsSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTurks and Caicos IslandsTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUS Minor Outlying IslandsUzbekistanVanuatuVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabwe Country Partner's Name (if applicable)Estimated Due Date or Baby's Date of BirthWho is your caregiver (your midwife or doctor)?What class would you like to register for?* Weekly Childbirth Essentials Class Weekend Childbirth Essentials Class Early Parenting Essentials Class Private Childbirth Essentials Class Breastfeeding Essentials Class Mommy Connections Mom & Baby Class Which Mommy Connections Class do you want to register for?* Sign up for our wait-list Please let me know when another date is available. Which Breastfeeding Essential Class do you want to register for?* November 20, 2019 (Wednesday)(7-9)(Arbour Birth Center) December 8th, 2019 (Sunday)(10-12 PM)(Aurora Midwifery Clinic) February 11th, 2020(Tuesday)(7-9PM)(Arbour Birth Center) March 31st, 2020(Tuesday)(7-9PM)(Arbour Birth Center) Please let me know when another date is available. Which Weekly Childbirth Essentials Class do you want to register for?* January 14th- February 25th, 2020(Tuesday)(Arbour Birth Center) March 3rd -April 14th, 2020 (Tuesday)(Arbour Birth Center) April 19th-May 10th, 2020 (Sunday)(Arbour Birth Center) May 5th-June 16th, 2020(Tuesday)(Arbour Birth Center) Please let me know when another date is available. Which Weekend Childbirth Essentials Class do you want to register for?* November 9th & 10th, 2019 9-4 PM (Arbour Birth Center) December 7th & 8th,2019 9-4 PM (Aurora Midwifery Clinic) January 11th & 12th, 2020 9-4 PM (Arbour Birth Center) March 14th & 15th, 2020 9-4PM(Aurora Midwifery Clinic) Please let me know when another date is available. Which Early Parenting Essentials Class do you want to register for?* December 8th, 2019 (Sunday)(2-4 PM)(Aurora Midwifery Clinic) February 25th, 2020 (Tuesday)(7-9 PM)(Arbour Birth Center) April 14th, 2020 (Tuesday)(&_(PM)(Arbour Birth Center) Please let me know when another date is available. How did you hear about us? *We'd love to say thank you!Is there anything you would like to ask or share before we talk?Terms and ConditionsI understand that submission of this registration form will secure a spot in my selected class. I also understand that it is my responsibility to contact Calgary Birth Essentials if I need to withdraw my registration (a non receipt of payment is not considered a withdrawal)Full payment must be received within 48 hours of registration. If the full payment is not received a deposit of 20% of the class total will be kept and the spot will be forfeited. If one decides to back out of their class a refund minus the deposit will be made if withdrawn with at least 3 weeks notice in advance of class start. If the request to withdraw is made less than 3 weeks before class start no refund can be made as there is more of a chance the spot will not be filled by someone else. (Withdraw due to medical reasons will be addressed on an individual basis.) So as to avoid participants registering and then not contacting us for withdraw, we will then be asking for payment from you either the full amount or the deposit amount depending on time of withdraw. This is to encourage participants to communicate effectively and respectfully with us. I have read and agree to the Terms of Service” EmailThis field is for validation purposes and should be left unchanged.