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Bookings

Birthing Workshop: Birth Better Together

Please fill in the form below to book your place in a Birthing Workshop.

The information you give here is confidential and will not be shared with anyone.

Payment information is provided at the bottom of the form. You will receive a booking confirmation email once your payment for the workshop has been received.


Workshop Date

Please select your workshop date.

 
 

Sunday, 2 - 5pm

19th November (last workshop for 2017)

George Burnett Leisure Centre

 

...more workshops coming in 2018.

Manning Road, Manning

   
     

Mother's Information

First Name:

Surname:

Phone:

Mobile:

Email:

Suburb:

How many weeks pregnant will you be at the time of the workshop?

What is your due date?

 

Birth Partner's Information

First Name:

Surname:

Birth partner's relationship to the mother:

 

Other

How did you find out about Barefoot Babes Yoga?

Google search

Leisure Centre

TheBump WA

Friend

Other:


Do you have any health conditions or complications with your pregnancy?
The information you give here ensures the highest level of safety and care can be met.

No

Yes

 

Twins

Gestational Diabetes

Pre-eclampsia

Placenta Praevia

Other

Details:

 

Payment Details

Direct Bank Deposit - online or at a bank branch

 

Amount:
Bank:
Account Name:
BSB:
Account Number:
Narration:

$90
BankWest
Hana Priest
306-042
0635940
your name

 

Comments:

 

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