Register for Childbirth Class
Please complete this registration form and we'll respond to your request. If you have any questions or concerns, please contact LaKieta Sanders at 919-323-5266.
Each series of classes is offered virtually and free of charge. Please select a group you would like to join:
*
Please Select
June Series on Tuesdays: June 2, 9, 16, 23 (5:15pm to 7:30pm)
July Series on Tuesdays: July 7, 14, 21, 28 (5:15pm to 7:30pm)
August Series on Mondays: August 10, 17, 24, 31 (5:15pm to 7:30pm)
What is your first and last name?
*
First Name
Last Name
What is your Postal / Zip code?
*
What is your email address?
*
example@example.com
What is your phone number?
*
Please enter a valid phone number.
Format: (000) 000-0000.
Where are you receiving prenatal care?
Where do you plan to give birth?
What is your estimated due date?
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Month
-
Day
Year
Date
How many times have you been pregnant?
0
1
2
3
More
Please describe any unique circumstances:
0/200
What do you hope to achieve from taking this class?
0/200
Do you have a preferred contact method?
Please respond by email
Please respond by phone
Submit
Should be Empty: