Mindfulness-Based Childbirth and Parenting Course Enrollment Form

Aloha! You have just made the decision to bring more relaxation, yoga, and mindfulness practices into your life! You will soon be training your mind, body and heart for childbirth and beyond. I’m so excited to meet you!

Thank you for filling out the form below to allow me to get to know you a bit before our class starts. This is a 9-week class that requires commitment on your part, but the returns on your investment will be abundant in ways you can’t yet imagine!

We meet once a week for 9-weeks, and each class is approx 2.5 hours. The cost to participate is $395 per couple for the in-person class, and $350 per couple for the virtual class.


tell me a bit about yourselves

Birthing Person's Name *
Birthing Person's Name
Spouse/Partner's Name
Spouse/Partner's Name
Phone Number
Phone Number
Address *
You are not required to have any prior experience with yoga, mindfulness, or meditation to participate in this class.
Please share any questions, reservations, concerns, worries, etc. here
I understand that this childbirth course will prepare me for labor, childbirth and parenting whether I choose to labor with an epidural, have an unmedicated labor, or have cesarean birth. Any and all birth preferences are welcome to attend. *