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Home > Birthing From Within Classes > Register

Birthing From Within
To Register For Classes:
Please fill out the following form and select a payment option.  Please click here for a schedule of upcoming classes.
(The information you provide is confidential and will not be shared with any third parties.)

Class Menu

Gourmet 6 Week Series
$160 per couple*
Includes: Six fantastic classes, class materials, art supplies, food for our final night of celebration, and a gift bag with a copy of Birthing From Within, Practice CD and other goodies.
Offered in Provo, Utah.
Delightful Private Classes
$250 per couple*
We will schedule a time (usually two sessions of 4-5 hours) to get together for class.   Call for more information. 
Includes: Class materials, art supplies, snacks,  and a gift bag with a copy of Birthing From Within, Practice CD and other goodies.
Hosted in your home.
 Red Tent Circles
 Free
Come enjoy a taste of what Birthing From Within has to offer  mindful women of all ages and stages.  At each meeting we will have a new dialogue topic or fun activity and plenty of time to visit.  All women 18 and up are warmly invited.  Pre-mobile babies also welcomed.
Dates and times vary.
*A couple can be a woman and her husband, partner, mother, friend or doula.  All types of birth partners are welcome and classes are designed to meet both the mother's and the father's/birth partner's needs.

Policies:
  • Your spot is reserved with your full payment.
  • Class registration and payment in full must be received no later than 14 days prior to the class start date. 
  • There is a maximum of 6 couples per series (4 for retreats).  Register early to reserve your spot! 
  • If minimum registration is not met you will be contacted 7-10 days prior to the start of class with the options of registering for another class, planning a private class or receiving a refund.
  • Refunds available until 14 days prior to class start date.
  • After that point, no part of the fee is refundable, even for missed classes, early delivery, or a change in your plans. Visit the Resources page to learn how to prepare for the classes.

Your Full Name:
Occupation:
Your Birth Date:
Partner's Full Name:
Occupation:
Partner's Birth Date:
Expected Due Date:
Preferred Class Location:
 Provo Home
Preferred Start Date:
Home Phone:
 ()-
Other Phone:
 ()-
Mailing Address w/ Zip:
Email Address:
Physician/Midwife:
Planned Birth Location:
Have you hired a doula?
 Yes No
If yes, who?
Other Children:
Name:
Birth Date:
Name:
Birth Date:
Name:
Birth Date:
Please list any complications or interventions with previous pregnancies or labors: (miscarriage, ectopic, pre-eclampsia, multiples, epidural, forceps, cesarean, episiotomy, etc.)


How did you hear about my childbirth classes?


Do you have any special needs regarding learning style that I should know about?


Please indicate anything else you would like me to know:


This is a "mail to" form.  Hitting the register button will open a window in your mail program with this information in the message box.  Simply click send and I will receive your registration. 

Once you have paid your fee (see payment options below), you will be fully registered.

I'm thrilled to be part of your preparation for birth!

Payment Options:
1. By Mail:
Please call Heather Duncan at 801-228-0183 for mailing address and instructions
2. Pay with Paypal
Paypal.com is an easy and safe way to send money over the internet.

Please Choose An Option
Discount Code

Notice: Paypal charges me a fee to take payments by credit card.  I am happy to cover this charge as part of your class fee.  If, however, you need a refund for any reason, this fee (between $5 and $7.50) will be deducted from your refund.
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