Registration and Confirmation

Workshop attendance is limited to 12 people.  Please call or email for directions. You will receive email confirmation that your space is reserved.

Attendance at this workshop is a privilege, not a right. The instructor reserves the right to deny participation in the workshop at any time, in which case a refund would be provided. 

  

Price and Discounts

see Registration Form below

  

Payment Plans

A non-refundable $100 deposit can be made by September 1. The remainder of the workshop payment can be made in cash on the first day of the workshop. If alternative plans are needed please contact the instructor. If the workshop is cancelled or postponed, your money would be returned.

  

Cancellations

Because of limited registration, there will be no refunds after September 1, 2010. You may find a replacement for yourself at the workshop though. Refund requests postmarked before that date must be sent in writing to Connie Sultana at the address below or via email to conniesultana@sbcglobal.com. 

  

Workshop Cancellation

There needs to be a minimum of 6 paid registrants in the workshop. If there are less, the workshop will be postponed and all money will be returned.

  

Further information:

Connie Sultana at (707) 588-8026 PST, conniesultana@sbcglobal.net

  

Make check payable and mail registration to:  

Connie Sultana, 933 Hacienda Circle, Rohnert Park, CA 94928-6005

  

 

Print and Mail Registration Form (or copy and paste it into a document for printing or just write)

 

Name_____________________________________ ___________________________________

Please print as you want your name to appear on your name tag and certificate

 

Address___________________________________

 

City,State, zip_______________________________________

 

Phone #s_(_____)___________________________

 

  

  

email_____________________________________

 

Profession_________________________________

 

Are you a CBE__, LLLI Leader__, EMT__, trained in... acupuncture__ acupressure__, midwifery__, nursing__, medicine__, massage__, aromatherapy__ other________?

You need not be to attend!

 

# of children__  # vaginal births __  # cesarean births__  # vbacs __ (You need not have given birth to be a doula!)

  

Please include a separate sheet of paper that discusses how you came to be interested in this workshop and your experience with birth. If you have given birth, please tell me what you think I would need to know about your experience. This may be 2 sentences, or as long as your desire.

 

____Intro and Doula Workshop – September 24, 25 and 26 2010:  $500 – Register before Sept 1 and receive $25 discount = $475 for the intro and workshop!

Registration includes 3 day program, handouts, food and certificate of completion for childbirth and doula training.

  

____ Doula Workshop only - September 25 and 26 $400–Register before Sept 1 and receive $25 discount = $375 for the workshop!

Registration includes 2 day workshop, handouts, food and certificate of completion.

 

____ Intro only – Sept 24 $100

Registration includes 1 day workshop, handouts, food and certificate of completion for childbirth education.

  

Your registration in this workshop indicates agreement to all stipulations in this brochure.

 

____I would be interested in talking with Connie about hosting an out-of-town participant at my home during the workshop.

 

PLEASE PRINT OUT AND MAIL THIS FORM IN WITH YOUR PAYMENT TO RESERVE YOUR SPACE.

Connie Sultana, 933 Hacienda Circle, Rohnert Park, CA 94928-6005