Name *
Name
Partner's Name
Partner's Name
Estimated Due Date (Guess Date)
Estimated Due Date (Guess Date)
Phone *
Phone
Address *
Address
Required for invoicing purposes.
The Fine Print *
Kansas City Family Birth agrees to adhere to the prices and length of classes listed on our website. By completing this online registration form, you are agreeing to pay the fee for your chosen class. Once payment is received, no refunds will be issued and all sales are final. YOUR REGISTRATION IS CONSIDERED INCOMPLETE UNTIL PAYMENT IS RECEIVED. Once your registration is received we will send an invoice for payment to the email address provided. Once the invoice is paid your registration is complete. I, the client, agree that I will in no way hold the instructor of this class or Kansas City Family Birth LLC responsible for any outcomes of my pregnancy, labor or birth. The client understands that Kansas City Family Birth LLC and all affiliates are NOT medical providers and all advice given should be used under direct supervision of a midwife or doctor. The client agrees and understands that labor and birth look different from person and to person and holds Kansas City Family Birth LLC blameless in any situation. Kansas City Family Birth will NEVER sell or distribute your information for personal gain. All information is used for registration and follow up purposes and will only be viewed and used by affiliates of Kansas City Family Birth LLC. By clicking, "yes" you are in agreement with the terms & conditions.