Enrolment form and Payment options


Mother’s name


Mailing Address








Preferred phone no


Mobile/Alternate phone no


Preferred email


Birthing Companion

(Name of spouse, partner, birthing partner)




Birthing Assistant (if applicable)


Relationship (doula, friend etc)


Care Provider Name and Title (eg Obstetrician)




Hospital/ Birthing Facility




When is baby expected?


How many weeks pregnant will you be when you begin classes?


Is this your 1st, 2nd, 3rd, etc baby?


Is this birth a VBAC or is there any important information you wish me to be aware of before classes commence?


I wish to enrol for the 2015 Hypnobirthing Course

4 consecutive Saturdays 9am-12am 
4 consecutive Thursdays 7pm-10pm

Morning tea or supper included


8 Hakea Crt
Mt Helen,
3350, VIC.

Ph: 0412715391

Where did you hear about Hypnobirthing Australia?





Tuition fee: $495 Group Classes

Fee includes practice CD’s (or MP3’s), and folio of resources

To reserve your place in this class, please complete this form and return it with a $150 non-refundable tuition deposit. Final payment is due 7 days prior to course start date

to: katrina@mindbodybirthing.com

Payment plan available to clients with limited income.

Payment can be made by cash or direct deposit

Direct Deposit Details: Commonwealth Bank,

K Foord, BSB 062692, Account number 24084698











Showing 3 items
Enrolment form and Payment options
Enrolment form and Payment options
Showing 3 items
Katrina Foord,
26 Feb 2015, 02:52