Test Personal InformationPregnant Person's Name: *Birthing Partner: E-mail: *Contact Number: *Estimated Due Date: *How did you hear about us? (If through a website/ search please be specific, if possible) Class InformationClass Start Desired: *The regular program is 5 weekly classes from the start date. It is recommended that you start the classes when you are 32 weeks pregnant or earlier.Please choose from the following...Wednesday, November 20 at 7:15pm -9:45pm at 10 Roden PlaceSunday, January 5 at 10:30am -1:00pm at 10 Roden PlaceWednesday, January 8 at 7:15pm -9:45pm at 10 Roden PlaceWednesday, February 19 at 7:15pm -9:45pm at 10 Roden PlaceSunday, February 23 at 10:30am -1:00pm at 10 Roden Place VerificationPlease enter any two digits *Example: 12This box is for spam protection - please leave it blank: