4
BIRTH BREASTFEEDING & BEYOND CLASS REGISTRATION First Name Middle Name Last Name Address Address (Line 2) City State ZIP Code Partner's Name E-mail Daytime Phone # Evening Phone # Cell Phone # Delivering Doctor Due Date

BIRTH BREASTFEEDING & BEYOND CLASS REGISTRATION · 2019-02-18 · Expectant parents receive the comfort of a personal touch during this ... A must for moms, dads, grandparents, older

  • Upload
    others

  • View
    0

  • Download
    0

Embed Size (px)

Citation preview

Page 1: BIRTH BREASTFEEDING & BEYOND CLASS REGISTRATION · 2019-02-18 · Expectant parents receive the comfort of a personal touch during this ... A must for moms, dads, grandparents, older

BIRTH BREASTFEEDING & BEYOND CLASS REGISTRATION

First Name

Middle Name

Last Name

Address

Address (Line 2)

City

State ZIP Code

Partner's Name

E-mail

Daytime Phone #

Evening Phone #

Cell Phone #

Delivering Doctor

Due Date

Page 2: BIRTH BREASTFEEDING & BEYOND CLASS REGISTRATION · 2019-02-18 · Expectant parents receive the comfort of a personal touch during this ... A must for moms, dads, grandparents, older

CHILDBIRTH CLASSES Expectant parents receive the comfort of a personal touch during this exciting time. Childbirth classes provide knowledge and skills that will help make your birth experience a positive one. Our instructors will help reduce the fear of childbirth and empower you to make informed choices about your baby's delivery. The Car Seat Safety and Infant/Child CPR classes are included in the Childbirth class! Classes will be held on Tuesdays from 6:30 p.m. - 9:00 p.m. for six sessions. Dates subject to change. Please select the class session you are interested in.

Class fee $65.00 February 5 - March 12, 2019April 30 - June 4, 2019August 6 - September 10, 2019November 5 - December 10, 2019Other - Note Date

FAST TRACK WEEKEND CHILDBIRTH CLASSES Same topics are presented in these classes as the six week sessions. Classes will be held Saturday and Sunday from 8:30 a.m. - 5:00 p.m. on both days. Our weekend courses fill quickly - register early if your class choices are limited. In addition, weather issues can cause challenges. We suggest that you do not plan other events on the weekend following your class in case we need to reschedule. Dates subject to change. Please select the class session you are interested in.

Class fee $65.00 January 19/20, 2019April 6/7, 2019July 13/14, 2019October 19/20, 2019

BREASTFEEDING CLASSES Not only is breastfeeding beneficial to your baby's health, but it can benefit you in ways you may not have realized. With a personal and caring technique, instructors will help expectant parents get prepared for breastfeeding. Classes will be held on Tuesdays from 6:30 p.m. - 9:00 p.m. for one session. Dates subject to change. Dates in October and December will be added.

Class fee $25.00 March 26, 2019April 23, 2019June 11, 2019July 23, 2019September 17, 2019

nck0750
Typewritten Text
nck0750
Typewritten Text
Page 3: BIRTH BREASTFEEDING & BEYOND CLASS REGISTRATION · 2019-02-18 · Expectant parents receive the comfort of a personal touch during this ... A must for moms, dads, grandparents, older

CAR SEAT SAFETY Which car seat is best for your child? Whether you have a newborn, toddler, or a small child, we can give you great tips on which car seat is best and how to use it. Certified instructors will use classroom instruction followed by hands-on-practice using various car seats and vehicles.

Class Fee: $25.00. Call for date and times

Summer dateFall dateWinter dateSpring date

INFANT & CHILD CPR A must for moms, dads, grandparents, older siblings, and caregivers! Instructors will teach you basic life saving skills for infants and children using materials from the American Heart Association. Don't get caught not knowing what to do!

Class fee $25.00. Call for dates & times

Summer dateFall dateWinter dateSpring date

FREE ELECTRONIC NEWSLETTER A free electronic newsletter, "My Baby Expectations" is available that includes tips and information timed with the birth of your baby.

Yes, I wish to receive itNo, I do not wish to receive it

Due Date

E-mail address for newsletter

Please contact me regarding financial

scholarships

YesNo

Please contact me regarding a

hospital tour

YesNo

Page 4: BIRTH BREASTFEEDING & BEYOND CLASS REGISTRATION · 2019-02-18 · Expectant parents receive the comfort of a personal touch during this ... A must for moms, dads, grandparents, older

OTHER REGISTRATION INFORMATION * Fees and dates are subject to change. Fees cover expectant mom and support person. * The instructor reserves the right to combine classes if needed. * Medicaid benefits DO NOT cover the cost of the class * Registration includes a booklet and helpful handouts.* Classes are held at Colorado Plains Medical Center Please make check payable to Colorado Plains Medical Center and mail to:

Colorado Plains Medical Center Attn: Debra Tolson, RN, ICCE, IBCLC

1000 Lincoln Street Fort Morgan, CO 80701 Upon receipt of registration payment, you will be mailed a confirmation of class dates. Please complete this registration form and select the submit button below to send electronically, or you may print the form and fill it out manually and mail it with your payment to the address above. For further information, please call Debra Tolson at 542-4378.