Register for a class now, and Cherie will contact you within 24 hours.
Can’t see a date that suits you? Contact Cherie, there is a chance dates can be altered.
Payment plans are available.
MONTHY PREGNANCY SUPPORT GROUP OPEN TO EVERYONE ONLY $20 PLEASE CONTACT CHERIE FOR MORE INFORMATION.
Choose your classNOV 18 + 20 + 25 + 27 (4 nights) SOLD OUTNOV 30 + Dec 3 + 5 (1 day + 2 nights) $550 ONE SPOT LEFTJAN 12 + 14 + 15 (1 day + 2 nights) SOLD OUTFEB 18 + 20 + 25 + 27 (4 nights) $550MAR 25 + 27 + APR 1 + 3 (4 nights) $550Calmbirth® Class PRIVATE $850Calmbirth® REFRESHER Class $395Calmbirth® REFRESHER Class PRIVATE $650Calmbirth® CAESAREAN birth Class $395Calmbirth® CAESAREAN birth Class PRIVATE $650
Mother's full name
Partner's/support person's name
Address (including postcode)
Phone
Your E-Mail
Mother's occupation
Partner's Occupation
Health fundYesNo
Dietary requirements (please specify)
How did you hear about Calmbirth?
Do either of you have any specific fears or phobias (e.g. water, heights, etc.)?
Are you or your partner currently being treated for any medical or psychological issues? If you are under the care of a psychologist or psychiatrist, please provide a letter of approval for you to attend the Calmbirth course.
Do you take medication/s on a regular basis? If yes, what medications do you take?
Is this the birth of yourFirst childSecond childThird childFourth childFifth child
Due date
Healthcare modelMGPPrivatePublicShared Care
Name of caregiver/s
Plan to birth at:HospitalBirth CentreHome
What are your feelings about the birth prior to commencement of the Calmbirth® class? Is there any specific fear you have regarding the birth or becoming a parent?
What would you like to get out of the Calmbirth program?
Do you give permission to Calmbirth to use any of your photos, testimonials and birth stories for print and online marketing?YesNo
Disclaimer: The Calmbirth® class program includes psychological & emotional preparation for birth. I understand that the delivery of the course will include guided relaxation as a means to facilitate emotional subconscious healing of fear and anxiety about childbirth.Yes