Journey through Childbirth and Early Parenting
REGISTRATION FORM :
Copy questions and e-mail them with your response to JeanneLyons@shaw.ca
or you may e-mail me and I will send you a copy of the form.
Please send your payment of $250 to Jeanne Lyons,
189 Walker Hook Rd., Saltspring Island, BC V8K 1P5
Please make your cheque payable to Jeanne Lyons.
Receipt of your payment is necessary to secure you place in the workshop.
Dates of workshop you are attending:
Name:
Address:
E-mail address:
Phone number:
Partner or support person’s name:
Expected due date:
Planned place of birth:
Name of midwife or physician:
Where did you hear about the workshop?
Do you have any other children and if so what are their ages?
Any additional information that you would think it would be useful for me to know?
Thank you,
Jeanne Lyons
JeanneLyons@shaw.ca
