Course Enrollment

To enroll in Color of Calm HypnoBirthing class please fill out the form below. After completing this form you’ll be directed to a payment options page. Note that listed start dates are flexible and will be made to accommodate you as well as other soon-to-be moms. If you have any questions prior to enrolling please contact Alanna at (760) 542-8090.

Your Name *

Your Partner's Name *

Home Address *

Email *

Phone Number *

Doula's Name

Care Provider & Birthing Facility

Emergency Contact Name *

Emergency Phone Number *

When is baby expected?

What is the class date you wish to attend? *

How did you hear about us?

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.

BY SIGNING WITH YOUR E-SIGNATURE, YOU HEREBY AGREE TO THE ABOVE STATEMENTS

After Submitting you will be directed to your payment options.