Prenatal Workshop Registration

Client Details

Full Name

Partner/Support Person's Name

Phone

Estimated Due Date

Workshop Date

Address

Care Provider

Intended Birth Location

Please list any allergies

Emergency Contact

First Name

Last Name

Phone

Relation

I would like to add-on a Motherhood Matters crewneck for $45.

(See website shop for examples)

Size

Colour

Pre-Workshop Survey

How knowledgeable do you feel regarding labour, birth, newborn care, and infant feeding?

Have you attended a prenatal class, childbirth education class, or similar course before?

What are you hoping to gain from this workshop?

I consent to photos/videos being taken of me/my birth support partner during this workshop. I understand these photos/videos may be used for educational, promotional, or social media content purposes.

Due to the nature of birthwork, short notice cancellations do happen. We will contact all attendees as soon as possible to inform them of the cancellation and provide full refunds.

By checking this box you acknowledge and understand that the workshop may be cancelled last minute.

I understand a minimum of two (2) weeks’ notice prior to the scheduled prenatal workshop date is required to receive a full refund. Cancellations made within two (2) weeks of the workshop date will be eligible for a fifty percent (50%) refund.

Waiver of Liability

I am participating in the Prenatal Education Workshop offered by Motherhood Matters Inc. I recognize that this workshop may require physical exertion that may be strenuous and may cause physical injury, and I am fully aware of the risks and hazards involved.

I understand that it is my responsibility to consult with a physician prior to and regarding my participation in the workshop. I represent and warrant that I am physically fit and have no medical conditions that would prevent my full participation in the workshop.

In consideration of being permitted to participate in the workshop, I agree to assume full responsibility for any risks, injuries, or damages, known or unknown, which I might incur as a result of participating in the workshop, including any and all activities done with the workshop group, with Motherhood Matters Inc, or as an individual at the event venue contracted by Motherhood Matters Inc.

In further consideration of being permitted to participate in the workshop, I knowingly, voluntarily, and expressly waive any claim I may have against Sara Pridgen, Sam Sankey, Motherhood Matters, its staff, employees, or agents, for injury or damages that I amy sustain as a result of participated in the workshop. I, my heirs, and legal representatives forever release, waive, discharge, and covenant not to sue Sara Pridgen, Sam Sankey, or Motherhood Matters, its staff, employees, or agents for any injury or death caused by their negligence or other acts.

I, for myself and anyone entitled to act on my behalf, waive, release, and covenant not to sue Motherhood Matters Inc., Alberta Counsel, Ledgeview building, Holistic Fertility Group, the venue and owners of said venue contracted by Motherhood Matters Inc., and any of its subsidiaries.

By signing below you agree to the above statements.

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edmonton prenatal and childbirth classes