The Breastfeeding Class with Illuminatal Doula Services
Please complete the information below to register for The Breastfeeding Class. Payment is due at the time of registration to secure your spot.
Common Law / Partnered
Street Address Line 2
State / Province
Postal / Zip Code
Where are you planning to give birth?
Who is your care provider for this birth?
Who referred you to this class?
Have you breastfed in the past? For how long?
Yes, less than 6 weeks
Yes, less than 6 months
Yes, 1 year or longer
No, attempted but not successful
No, never attempted
No, first baby
What questions or concerns do you have about breastfeeding?
Illuminatal offers a variety of classes for new and expectant parents. What other topics are you interested in?
preparation for natural childbirth
preparation for medicated childbirth
coping techniques and comfort measures for labor
the amazing placenta and its benefits
car seat safety
baby health and wellness
baby gear and essentials
Additional Comments or Requests
I agree to pay $50 for the group class to be held at West University Wellness, 5180 Buffalo Speedway, Houston, TX. I understand that payment is due in full with registration. I understand that elements outside of Heather Barrett's control may cause a postponement of my class, including but not limited to births, illness, traffic, or weather. I understand that in the event of postponement, Heather will notify me as soon as possible. The Thursday following the class will be available for make-ups if any session is cancelled by Heather. I agree to release and hold harmless Heather Barrett and Illuminatal Doula Services from any claims that may arise from the class or any information taught therein.
I agree to the terms described above.
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