Sign up for the english course weekend 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*Sunday 26th November 10.00-15.00 Den BoschSunday 17th December 10.00- 15.00 Den BoschDue 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