Sign up for the english course Registration form Prettig Bevallen Name mother* First name Last name Name partner* Firts name Last name Adress* Street + number Postal code City Telefon numbre*E-mailadress* We want to follow the weekend childbrth-course in English on*Saturday April 1-15th 10 a.m.-12 a.m.Sunday May 7th from 10 a.m. - 3 p.m.Saturday June 3-10th 10 a.m.-12 a.m.Sunday July 23th from 10 a.m - 3 p.m.Sunday September 17th from 10 a.m.- 3 p.m.Saturday November 4-11th from 10 a.m.-12 a.m.Due date*Is this your first baby* Yes No If no, please describe shortly how the first childbirth wentNaam midwife or gynaecologist*Questions and/or special wishes for lunch on Sunday course regarding diet or allergies?* I hereby give permission to process the above data. The processing is necessary for the purpose of providing our services and providing the course. You have the right to withdraw this consent at any time. Δ
