YogaLua

Yoga, HypnoBirthing, HypnoMothering, Aromatic Medicine, Intuitive Parenting, Natural Wellness

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HypnoBirthing Registration

HB Registration

  • Husband, partner, relative, friend...
  • Date Format: MM slash DD slash YYYY
  • If you were referred by someone, please let me know so I can thank them!
  • If you pay a deposit now, then the balance will be due at the first class (unless otherwise arranged).
  • PayPal: You will be directed to the PayPal platform to complete your payment upon submitting this form.
    Venmo: Please send payment to @Courtney-Menezes
  • Liability Waiver

    I hereby state that I am enrolling in the HypnoBirthing class of my own free will and with the understanding that this is a program designed to teach me to use my own natural abilities to bring my mind and my body into a state of relaxation. I further understand that the content of these classes is in no way intended to be represented as medical advice nor as a prescription for medical procedure. I am aware that I should seek the advice of a health-care provider to answer any health-related or pregnancy-related issues surrounding my pregnancy, my labor, or my birth. I therefore agree that I will in no way hold the instructors of the HypnoBirthing classes, or the HypnoBirthing Institute®, its owner, or its representatives responsible for any special circumstances that could arise as a result of my pregnancy, my labor, or the birth of my child; and I agree that neither I nor any member of my family will make any claim or initiate any suit against any of the above-named parties now or at any time in the future.
  • Please sign using your touchscreen device, touch pad or mouse. You may use the small circular 'refresh' icon below on the right to clear your entry and start again.
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