reg form

Big Belly Services

REGISTRATION INSTRUCTIONS

Instructions:

1) To register, please complete this form and press the Submit button.

2) A deposit is due at the time of registration to secure your space in class.

3) Full payment is due two weeks prior to class beginning.

4) To pay a deposit or a class fee using PayPal, simply return to this form after pressing the Submit button.

5) If you have already registered and need to pay your balance, just proceed to the bottom of the page and use the appropriate PayPal button (no need to complete the form again).

6) You may also register or pay via regular mail; just follow the instructions at the bottom of this page.

7) Please read the Payment and Refund policies below.

Pregnant Woman's Name:

Partner's Name:

Due date:

mm/dd/yy

Your mailing address:

(street)

(city, state, zip)

Your email address:

Your phone numbers:

home

work

cell

other

Is this your first child?

Yes No

If not, what are the age(s) of your other children?

Where are you planning to have your baby?

Who is your midwife or doctor?

Where did you hear about my classes?

Anything else you'd like us to know?

Which classes do you want to take?

        Childbirth Preparation Classes:

7-week evening series ($75 deposit required)

Weekend immersion     ($75 deposit required)

Refresher class               ($25deposit required)

VBAC class                  ($25deposit required)

       After Birth Series:
             Breastfeeding Basics
             Postpartum Planning

             Newborn Care

       One-time Classes:

             Early Pregnancy Seminar   To register for the Early Pregnancy Seminar, go to the Great Starts website here.

       For the following classes, you will be given payment instructions when you register.

            Cloth Diapering

            Carrying Your Baby

            Infant Massage Series

To prevent automatic form submissions:

please enter the number you see in the picture below here:

You must click here to submit your registration form before making any payments:


WARNING: Before making any payments below, click the 'Submit' button above or your registration information will be lost! Please see Note below regarding PayPal payment refunds.

PAYMENT SECTION

Childbirth Preparation Classes deposit - $75

Childbirth Preparation Classes full fee - $250

Childbirth Preparation Classes balance (after deposit) - $175

After Birth deposit or One-Class fee - $45

After-Birth Series full fee - $120

After Birth balance (after deposit) - $75

Refresher or VBAC Class deposit - $25

Refresher or VBAC Class full fee - $100

Refresher or VBAC Class balance (after deposit) - $75

Or, you can open this form as a Word Document, print and complete it, and return along with your deposit to:

Big Belly Services

2366 Eastlake Avenue E, Suite 428

Seattle, WA 98102

Payment Policy: Your payment reserves your spot in class. If you miss a class for any reason, no deduction or refund is made to your fees.

Deposits are due at the time of registration. The balance of the class fee is due two weeks prior to the first class.   An invoice will be sent as a reminder to you prior to payment due dates.

Sliding fees are available; more information can be found here. Please contact Carrie in advance of class to make any payment arrangements.

Refund Policy: Payments are refundable prior to two weeks before the class starts. After two weeks, you may receive a refund if your space in class is filled; otherwise, your payment will be forfeited.. All refunds will be issued via check. A $10 administrative fee is deducted from all refunds.

Note regarding PayPal payment refunds: Big Belly Services offers PayPal as a convenience for its customers. Big Belly Services absorbs the cost of PayPal fees when payments are made. However, if refunds are requested for a payment made with PayPal, the PayPal fees (approximately 3%) will be deducted from the refund amount.