HYPNOBIRTHING REGISTRATION FORM
Please complete the form below. I will contact you within 24 hours to confirm enrolment. Thank you!
Birth partner's name
Street Address Line 2
Estimated Due Date
Date Picker Icon
GROUP hypnobirthing course - ($595)
ONLINE hypnobirthing course via zoom ($545)
PRIVATE hypnobirthing course - ($925)
Hypnobirthing REFRESHER - ($290)
Positive CAESAREAN Course - ($395)
Hypnobirthing INTENSIVE Course - ($660)
Hypnobirthing course dates you wish to enrol in.
Care provider name
How many weeks pregnant will you be when you begin classes?
Is there any important information you need me to be aware of before classes commence?
Eg previous pregnancies, medical or emotional health concerns.
Do you have any dietary requirements or food allergies?
Do you have any questions about the program? Please leave them here and Rosie will be in touch asap.
To secure your place, a $150 non-refundable tuition deposit is requested. Final payment is due 7 days prior to course start date. Payment can be made by direct deposit or PayPal. Please note that your enrolment is not confirmed until deposit has been received.
Direct Deposit : Rosie Fitzclarence BSB: 063551 Acc. 10148447 PayPal : email@example.com (debit or credit card).
Should be Empty:
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