Today’s Date____________              Series Start Date_______________

Name________________________ Coach’s name__________________


Phone________________________  E-mail ________________________

Approximate Due Date_________________

Birth Attendant (midwife/doctor)__________________________________

Birth Place (home/birth center/hospital)_____________________________



(Tear along dotted line. Return top portion with $50 deposit, retain bottom portion for your records.)


Series Start Date:  ___________________

Series End Date:  _____________________          

Class Location:  Frugal Resale, 740 Haddon Avenue, Collingswood, NJ 08108

Time:  6:30 PM - 9:00 PM

Fee:  $350.00     Deposit:  $50.00


Recommended Reading:       Natural Childbirth the Bradley Way

(before coming to class)             -by Susan McCutcheon

                                                Ina May’s Guide to Childbirth

                                                      -by Ina May Gaskin



Included in Course Fee:        Bradley Student Workbook

Access to lending library of books and videos

More than 25 hours of instruction


Just a reminder: To ensure a place in this series of classes, please return the top portion of this registration form along with a deposit of $50.  The balance of the fee ($300) will be due at the conclusion of the first class.  Class size is limited (usually to 4-5 couples) and couples are turned away due to other registrants, therefore deposits are nonrefundable. PLEASE MAKE CHECK PAYABLE TO ME (Morgan Robinson)


Please return the top portion of this form to me at the following address:

33 Washington Ave., Collingswood, NJ 08108