HypnoBirthing® Course Enrollment Form

Please complete the following enrollment form to join the HypnoBirthing® class.

Mother's Name (required)

Mother's Preferred Email (required)

Mother's Alternate Email

Mailing Address (required)

City, State, Zip Code (required)

Preferred Phone (required)

Alternate Phone

Birthing Companion Name

Relationship

Birthing Assistant Name

Relationship

Care Provider

Care Provider City

Birthing Facility

Birthing Facility City

When is baby expected?

How many weeks pregnant will you be when you begin class?

I wish to enroll for the HypnoBirthing class beginning (date): (required)

Questions or comments

HypnoBirthing® Course Enrollment Agreement

I hereby state that I am enrolling in the HypnoBirthing® class of my own free will and with the understanding that this is a program designed to teach me to use my own natural abilities to bring my mind and my body into a state of relaxation. I further understand that the content of these classes is in no way intended to be represented as medical advice nor as a prescription for medical procedure. I am aware that I should seek the advice of a health-care provider to answer any health-related or pregnancy-related issues surrounding my pregnancy, my labor, or my birth.

I therefore agree that I will in no way hold the instructor of the HypnoBirthing® classes, or the HypnoBirthing Institute®, its owner, or its representatives responsible for any special circumstances that could arise as a result of my pregnancy, my labor, or the birth of my child; and I agree that neither I nor any member of my family will make any claim or initiate any suit against any of the above-named parties now or at any time in the future.

I agree to the terms and conditions above.

Please scroll down below after clicking on Submit to make your payment and secure your space in class.

Payment Options

  • You may pay the $375.00 class cost for all 5 classes here via PayPal. Please note, there is an additional $10.00 charge to compensate for the PayPal Credit Card Processing Fees for full payments made online, bringing the total $385.00.
  • Or, you may pay the $50.00 deposit here via PayPal, AND complete my Financial Agreement Form (click below) and pay the $325.00 balance when you attend your childbirth classes. If you choose to pay the balance in the classes, I accept cash or checks. Payment in full must be made by your last class. Space is limited & classes fill fast. Once you have completed your forms and paid your deposit, you are guaranteed a spot in the class series you’ve selected.

How to reserve your space in a class

  • Once you have decided on your class series, complete the Enrollment Form and click on the ‘Submit Class Enrollment’ button at the bottom of the page. You will receive a confirmation of your enrollment.
  • Next, select your Payment Option, following the steps to select your Payment Preference.
  • If you choose to pay ONLY the $50.00 deposit now, you MUST complete the Financial Agreement Form (click below).
  • If you have any questions, please contact Debbie Catz by phone or e-mail for information on private HypnoBirthing classes or to host a class in an area outside of Sonoma: 707-721-1500 or 415-895-5559 or Debbie@NorCalHypno.com.
Select Payment Preference
Complete Financial Agreement Form