Hypnobirthing Booking Form

Name *

First

Last

Birth Partners Name (if applicable)

First

Last

Email *

Phone Number *

Partners Phone Number (if applicable)

Address 1 *

Address 2

Town *

Postcode *

Baby Due Date dd/mm/yyyy *

What number baby is this? *

Where do you plan to have your baby? *

Do you have anything you want me to be aware of?

Which hypnobirthing course do you want to book?

Where did you hear about Earthy Births?

Do you also intend to purchase placenta remedies?

I do a 10% discount for people who want placenta remedies as well as completing a hypnobirthing course.

Terms and Conditions - Yes to agree

1. Deposit of £50 is non-refundable. 2. Earthy Births respects your right to privacy and will protect the general information that you have provided as part of your application to attend any of our courses. We will not share your information with 3rd parties. We will protect your data from misuse, unauthorised access, disclosure and alteration to the best of its ability. By accepting you agree to us storing your information securely inline with the GDPR act of 2018. 3. Using the techniques taught to you is not a substitute for the advice of or the presence during birth or any part of pregnancy or labour of a qualified medical practitioner, midwife or obstetrician. It does not represent in fact or otherwise an alternate to appropriate medical care or for professional medical advice in any way shape or form. Any questions or doubts that you have about the use of this course by you or any third party in any part should be discussed by you with your medical caregiver and the safety of or the appropriateness of this programme to you or any third party whom you represent be confirmed with your medical care giver prior to undertaking the programme.

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