Class Enrolment form

Please complete the form below to enrol in our classes. PLEASE SELECT THE SUBMIT BUTTON AT VERY BOTTOM OF BOOKING PAGE - SCROLL PAST ALL THE CLASS DATES - TO SEND THE BOOKING OR IT WONT GO THROUGH! THANK YOU - A CONFIRMATION SHOULD POP UP IMMEDIATELY.    We will contact you via email to confirm your booking within seven days- IF NO RESPONSE PLEASE TRY AGAIN OR CALL US.
Full Name*
Year of birth
What ethnicity? Maori, Pacific Island, Pakeha, Indian, Chinese, Other Asian, European, other? *
Country of birth
Email address*
Contact phone number*
Baby's due month *
1st baby
Support person's name
Support Person's Ethnicity:- Maori, Pacific Island, Pakeha, European, Indian, Chinese, Other Asian, other
SUBURB YOU LIVE IN*
Midwife's Name
How did you hear about the classes? Midwife, Google, Hospital team, friends?
Select the classes you wish to book for then enter submit at bottom of the page:  
Churton Park Community Centre Monday 9 16 23 30 November 2020 7-15 pm to 9.15 pm : 9 Nov 2020
Cancer Society Newtown Wednesday 4, 11, 18 November 6 pm to - 8.30 pm : 4 Nov 2020
Cannons Creek Tuesday morning 10 17 24 November and Dec 1 from 10am to 12.00 : 10 Nov 2020
ZOOM CLASS Online Wednesday 2 9 16 December 2020 6-45 pm to 8.45 pm. we will email a link the day before class : 2 Dec 2020
Cancer Society Newtown Saturday 21 November 9 am - 3.30 pm: 21 Nov 2020
Kenepuru Hospital Education Centre Monday 11 18 25 Jan 2021 6 pm to 8-30 pm: 11 Jan 2021
Cannons Creek Tuesday morning 2 9 16 23 February 2021 from 10am to midday : 2 Feb 2021
Cancer Society Newtown Wednesday 3 10 17 Feb 2021 from 6 pm to 8-30pm : 3 Feb 2021
Cancer Society Newtown Saturday 1 day class 16 Jan 2021 starts 9 am to 3.30 pm : 16 Jan 2021
Churton Park Community Centre Monday 8 15 22 29 March 2020 at 7.15 pm to 9-15pm : 8 Mar 2021
ZOOM CLASS online Wednesday March 3 10 17 6.45 pm to 8.45 pm : 10 Mar 2021
Cannons Creek Tuesday Morning 6 13 20 27 April 2021 from 10am to midday: 6 Apr 2021
Cancer Society Newtown Wednesday 7 14 21 April 2021 from 6 pm to 8.30 pm : 7 Apr 2021
Churton Park Community Centre Monday 10, 17, 24 31 May 2021 from 7.15pm to 9.15pm : 10 May 2021
Cancer Society Newtown Saturday 1 day class 15 May 2021 from 9 am to 3.30 pm plus tour : 15 May 2021
Full Name*
Year of birth
What ethnicity? Maori, Pacific Island, Pakeha, Indian, Chinese, Other Asian, European, other? *
Country of birth
Email address*
Contact phone number*
Baby's due month *
1st baby
Support person's name
Support Person's Ethnicity:- Maori, Pacific Island, Pakeha, European, Indian, Chinese, Other Asian, other
SUBURB YOU LIVE IN*
Midwife's Name
How did you hear about the classes? Midwife, Google, Hospital team, friends?
Select the classes you wish to book for then enter submit at bottom of the page:  
Churton Park Community Centre Monday 9 16 23 30 November 2020 7-15 pm to 9.15 pm : 9 Nov 2020
Cancer Society Newtown Wednesday 4, 11, 18 November 6 pm to - 8.30 pm : 4 Nov 2020
Cannons Creek Tuesday morning 10 17 24 November and Dec 1 from 10am to 12.00 : 10 Nov 2020
ZOOM CLASS Online Wednesday 2 9 16 December 2020 6-45 pm to 8.45 pm. we will email a link the day before class : 2 Dec 2020
Cancer Society Newtown Saturday 21 November 9 am - 3.30 pm: 21 Nov 2020
Kenepuru Hospital Education Centre Monday 11 18 25 Jan 2021 6 pm to 8-30 pm: 11 Jan 2021
Cannons Creek Tuesday morning 2 9 16 23 February 2021 from 10am to midday : 2 Feb 2021
Cancer Society Newtown Wednesday 3 10 17 Feb 2021 from 6 pm to 8-30pm : 3 Feb 2021
Cancer Society Newtown Saturday 1 day class 16 Jan 2021 starts 9 am to 3.30 pm : 16 Jan 2021
Churton Park Community Centre Monday 8 15 22 29 March 2020 at 7.15 pm to 9-15pm : 8 Mar 2021
ZOOM CLASS online Wednesday March 3 10 17 6.45 pm to 8.45 pm : 10 Mar 2021
Cannons Creek Tuesday Morning 6 13 20 27 April 2021 from 10am to midday: 6 Apr 2021
Cancer Society Newtown Wednesday 7 14 21 April 2021 from 6 pm to 8.30 pm : 7 Apr 2021
Churton Park Community Centre Monday 10, 17, 24 31 May 2021 from 7.15pm to 9.15pm : 10 May 2021
Cancer Society Newtown Saturday 1 day class 15 May 2021 from 9 am to 3.30 pm plus tour : 15 May 2021
 
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