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!

Our next 9-week course begins May 25th and each class will be held for 2.5 hours, from 10:30 am to noon at 20 Dowsett Avenue in the Nu’uanu area of Honolulu. The cost to participate for the 9-week course is $385 per couple.


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. *