Virtual Childbirth Class Registration Form
We are so excited for your interest in Center for Indigenous Midwifery's 3-hour, short & sweet, childbirth education workshop for Indigenous families.  You and any support people you choose to invite are welcome to attend this class with you.  *This form should only take a few minutes to complete.  Looking forward to meeting you!

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Email *
Does your family identify as Indigenous?  (Self-identified, this can be the birthing person or any other parent).  (Please understand that this is a requirement for participation in this class) *
Full Name *
What is your estimated due date?  (Please note:  in consideration of privacy, this class is for current pregnant families only.  Thank you) *
Phone Number *
After our class time together, we would love to gift you a small herbal care kit for your postpartum time.  What is a mailing address we could send it to?  (We apologize, but due to restrictions and expense, we are unable to mail these kits out-of-country) *
Classes are always 10am-1pm Pacific Standard Time.  Please know that you are welcome to attend at any point in your pregnancy, though the most ideal time to attend class would be late 2nd trimester/early 3rd trimester (so that you have time to practice some of the comfort measures for your upcoming labor and birth).  Class dates can be found on social media and our website.  In addition, we will email you a Zoom link and class reminder the week of each class session.  That way, you can attend whichever class session is most convenient for you.  Any other questions, comments, or requests of us?
A copy of your responses will be emailed to the address you provided.
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