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Name *

Support Person's Name

Due Date *

Phone *

Email *

Address *

City *

City

Postal Code *

Postal Code

State *

State

Previous Birth Experience

Please note any previous experience with birth (i.e. been a support person or already have a child).

Expectations of the Workshop

What do you want to get out of the workshop?

Additional Information

Please select a workshop *

Date *

Dropdown *

Payment Method

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Full payment or deposit of $100 can be made to: Account Name: Birth and Babes P/L BSB: 033-264 Account Number: 243322
Please leave your name as a reference when paying by bank deposit or online Or post cheque to 44A Avondale Drive, Wodonga 3690