Active Birth Workshop Form

Better birth bundle request

Thank you for applying for the Better Birth Bundle. Please complete the following form. Using your preferred dates we will send you a booking confirmation via emails for both workshops. Your investment for the pregnancy active birth and couples active birth workshops will be $550 (you have saved $50).

Couples Active Birth Workshop

Transformational Birth Workshop

Mother's Name

First Name

Last Name

Partner's Name

First Name

Last Name

Phone

Email Address

Due Date

YYYY

Occupation

Mother and Partner

Where are you birthing and with whom

Hospital/Birth Centre/Home and GP/Obstetrician/Private Midwife/Doula

What Antenatal Preparation have you done or planning to do

Hospital classes/other antenatal classes and when

Do you have any pregnancy related health issues

How many children do you have

This is our first child

One child

Two or more children

Blended family

Postcode

How did you hear about yogababy

How would you like to participate?

Face-to-face workshop

Live-streaming via Zoom

Agreement

I am aware that participation in the workshop includes physical activity and will inform the teacher if I am a) suffering from any injury or illness, or any other conditions that may affect my participation; b) feeling unwell or experiencing any physical discomfort during the sessions. My partner and I acknowledge the increased risk of contracting the Coronavirus (COVID-19) by attending a group activity. I am aware that as a pregnant woman, I am more vulnerable to infection by COVID-19 and its variants and I am at increased risk of complications if contracted. During the workshop, we will adhere to the Australian and State Government Departments of Health guidelines. If either of us has any of the following symptoms:- shortness of breath, cough, sore throat, fever, loss of taste or smell, vomiting, or diarrhea we will notify the yogababy office via email to discuss our options.

I agree

I disagree