Birth Center Mail in Form
Print out and mail in today!
Name: ________________________________________________________
Address:_______________________________________________________
City: ______________________
State & Zip:_____________ ___________
Phone (Day):________________
Phone (Evening): ____________________
Sign me up for
:
Baby Beginnings $50 per couple - Dates:
Baby Beginnings - Saturday Only $50 per couple - Dates:
NFL - New Father's League *$5 - Dates:
Breastfeeding Course $5 - Dates:
Basic Newborn Safety *$5 - Dates:
Name of Physician:
_________________________________
Baby's Due Date:
_________________________________
Amount enclosed: $
_________________________________
You may register for more than one class.
* Free with Baby Beginning registration.
Registration and Cancellation Policy
Classes are limited in size and fill quickly. We strongly recommend that you register as early as possilbe.
Payment is required at time of registration. We accept Visa, MasterCard and Discover.
We reserve the right to cancel any program for lack of participation or inclement weather. In such cases, a full credit will be applied toward another class. cancellation policy requires a seven-day notice for a refund. Prices, dates and times are subject to change.
Refund Policy: Requests should be made before the date of the class:
Call 584-4355.
Make Checks Payable to
: Parkview Medical Center
Mail to
: The Milky Way - Parkview Breastfeeding Center
1316 N. Grand Avenue
Pueblo, CO 81003