Class Registration

You are registering for:
Childbirth Preparation
Location: Family Birth Center 3rd floor
Instructor: Childbirth Instructor
Dates:  Thu May 8, 2014 6:30 PM - 9:00 PM
Thu May 15, 2014 6:30 PM - 9:00 PM
Thu May 22, 2014 6:30 PM - 9:00 PM
Thu May 29, 2014 6:30 PM - 9:00 PM
Thu June 5, 2014 6:30 PM - 9:00 PM
Thu June 12, 2014 6:30 PM - 9:00 PM
Fee: $110

Please give us your contact information:
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Due Date:
Doctor's Name:
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DSHS ProviderOne card: