April 26 - May 3, 2008 Weekend Class
May 6 - May 27, 2008 Condensed Four Week Summer Class
June 4 - 25, 2008 Condensed Four Week Summer Class
June 7 + 14, 2008 Weekend Class
July 8- 17, 2008 Condensed Two Week Summer Class
August 16 + 23, 2008 Weekend Class
September 9 - October 14, 2008 Six Week Class
September 27 + October 4, 2008 Weekend Series
November 4 - December 9, 2008 Six Week Class
December 6 + 13, 2008 Weekend Class
Private Class in your home; do you have a DVD player? 
Private Class in the Birth Roots classroom

Class dates are subject to change.  As well, we cannot guarantee that the class you have selected will be available.  In the event that it is full, we will contact you to discuss other options.

Mother's Name:    Mother's Age: 

Partner's Name/Name of person attending the class with you:   

Is your partner attending the birth?

Address:

City:    Postal Code: 

Phone Number: 

Work Number:  Can you be reached at work?

Email Address:    Please provide an email address where can reach you now as well as postpartum, when you may be on maternity leave.

Would you like to be added to Birth Roots Connections, a listserv for our clients to share information and experiences? (You can unsubscribe from this listserv at any time.) Yes No

Due Date:  

Planned Place of Birth:
Home St. Boniface Hospital Women's Hospital

Is your caregiver a:
  Midwife General Practitioner Obstetrician

Midwife or Doctor's name:   

Doula's name, if applicable:

Are you planning to breastfeed? 
Yes No

If you have other children, how old are they? 

If applicable, please briefly describe your previous births.

If you have taken Birthing Classes before, where did you take them?  

Which books you have read about pregnancy and childbirth? (Please check all that apply)
Birthing From Within
Books by Sheila Kitzinger
Books by William & Martha Sears
What to Expect When You're Expecting
Girlfriend's Guide to Pregnancy
Other, please specify:
I haven't read any books
 

Please list any specific topics you would like addressed in your class or concerns you have.

How did you hear about us? 

Please press the 'Submit' button to process your registration