Bloom Birth Concierge Lamaze Class Pittsburgh

Group Class Registration

Contact Information

Name

Birth Partner Name

Estimated Due Date

Planned Place of Birth

Address

City, State and ZIP Code

Phone Number

Email Address

Food Allergies?

Classes & Additional Services

Thoughtful Childbirth

Wednesday Series: 1/29-2/19 from 6-9pm ($225.00)

Would you like to add other services?

Prenatal Consultations ($200.00)
Virtual Birth Doula Support ($225.00)

Total

$0.00

Terms & Agreements

In the event of illness on the part of the instructor, a birth, or inclement weather, class may be rescheduled.

By completing this online registration form, you are agreeing to pay the total amount due for the services selected above. Once payment is received, no refunds will be issued and all sales are final.

We require a minimum of 4 couples per group class. If we do not meet that minimum, class may be rescheduled. If a class must be cancelled, your payment will act as a credit toward a private class or will be refunded in full.

For questions, please contact Bloom Birth Concierge at (412) 330-1159 or Hello@BloomBirthConcierge.com.

I have read and agree to the terms above.

Billing Information

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Card Number

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Expiration Date

Address

City, State and ZIP Code

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