Childbirth and Baby Care Classes – Registration Form

Please print this form and return it with your check or money order to:
Saint Francis Hospital
Parent Education Coordinator/DB
701 N. Clayton Street
Wilmington, Delaware 19805

Payment must accompany registration. We will confirm your registration by mail.
No phone registrations will be accepted. Register early to avoid disappointment.

 

Name_____________________________________________________________

Address____________________________________________________________

City ______________________________________________________________

State_________________________________________ Zip__________________

Home Phone________________________________________________________

Work Phone________________________________________________________

Insurance Carrier____________________________________________________

Support Person______________________________________________________

Baby’s Due Date_____________________________________________________

Doctor____________________________________________________________

Age(s) of other children________________________________________________

 

Check your first and second choice of evenings to attend the class.

__Monday       __Tuesday       __Wednesday       __Thursday

 

Check the class or classes you wish to attend.

__Labor and Delivery – Childbirth Readiness Classes
Four two-hour sessions. Weekday evenings from 7:00 pm – 9:00 pm
Cost: $60

__Buttons and Bows – All About Baby
One two-hour session. Weekday evening from 7:00 pm – 9:00 pm
Cost: $15

__Breastfeeding Your Baby
One two-hour session. Weekday evening from 7:00 pm – 9:00 pm
Private classes are conducted during the day if someone is unable to schedule an evening class.
Cost: $15