Class Registration Name First Last Email PhoneAddress Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAntigua and BarbudaArgentinaArmeniaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBosnia and HerzegovinaBotswanaBrazilBruneiBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCosta RicaCôte d'IvoireCroatiaCubaCuraçaoCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEast TimorEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEthiopiaFaroe IslandsFijiFinlandFranceFrench PolynesiaGabonGambiaGeorgiaGermanyGhanaGreeceGreenlandGrenadaGuamGuatemalaGuineaGuinea-BissauGuyanaHaitiHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsraelItalyJamaicaJapanJordanKazakhstanKenyaKiribatiNorth KoreaSouth KoreaKosovoKuwaitKyrgyzstanLaosLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMauritaniaMauritiusMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew ZealandNicaraguaNigerNigeriaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPolandPortugalPuerto RicoQatarRomaniaRussiaRwandaSaint Kitts and NevisSaint LuciaSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSpainSri LankaSudanSudan, SouthSurinameSwazilandSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTogoTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVatican CityVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.YemenZambiaZimbabwe 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?* Sept 25th - Nov 20, 2017 (Elevate Life Chiropractic) Jan 22nd - Mar 19th, 2018 (Location TBA) Please let me know when another date is available. Which Breastfeeding Essential Class do you want to register for?* November 22nd (Wednesday) 7-9:15 PM (Arbour Birth Center) January 7th, 2018 (Sunday) 10:15-12:30 PM (Arbour Birth Center) February 7th, 2018 (Wednesday) 7-9:15 PM (Arbour Birth Center) Please let me know when another date is available. Which Weekly Childbirth Essentials Class do you want to register for?* January 10th - Feb 21st (Feb 14 class on Feb 15), 2018 (Wednesdays) (7-9)(Arbour Birth Center) March 4th-March 25th, 2018 (Sunday's)(5-8:30)(Arbour Birth Center) March 7th-April 18th, 2018 (Wednesdays)(7-9 pm)(Arbour Birth Center) May 2nd-June 13th, 2018(Wednesday)(7-9)(Arbour Birth Center) Please let me know when another date is available. Which Weekend Childbirth Essentials Class do you want to register for?* April 21st & 22nd, 2018 (9:00-4:00)(Arbour Birth Center Please let me know when another date is available. Which Early Parenting Essentials Class do you want to register for?* February 21st, 2018 (Wednesday) 7-9:15 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” NameThis field is for validation purposes and should be left unchanged.