Become a Certified Birth Doula Birth Doula Training Registration & Payment Form REGISTRATION FORM - DONA Birth Doula Training Workshop Class options vary. You are able to register for the 1-Part Introduction to Childbirth for Doulas Class, the 2-Part Birth Doula Training Workshop only OR combine the Intro and Doula Training Class into a 3-Part Course. Unless otherwise listed on our Calendar, classes are most often offered in 1 - 3 parts. Some courses during the year will be split into more than 3 parts. Classes may include as many as 6 total parts ("parts" = classes). Visit our Pricing Page or FAQ Page for details and answers to many of your questions. Contact us HERE if you have more questions. CLICK HERE FOR OUR CALENDAR Your Full Name (First/Last):(Required) First Last Preferred Phone #:(Required)Alternate Phone #:I consent to receiving text messages so MC or my DONA Trainer can communication with me:(Required) Yes No NO marketing material will be sent to you. Text is used as a form of communication to answer your questions or follow up with you regarding your Training Workshop Classes or DONA Certification. Preferred Email:(Required) Alternate Email: Your Full Address:(Required) Street Address City State / Province / Region ZIP / Postal Code Title of the document DONA TRAINING WORKSHOP CLASS MENU & PAYMENT OPTIONS IN-PERSON CLASS LOCATION - Mount Sinai Medical Center, Miami Beach, FLCLICK HERE for Parking Fees at Mount Sinai (Class Fee does NOT include Parking Fee)VIRTUAL CLASSES: Online - Google MeetPRIVATE GROUP OR SOLO CLASSES AVAILABLE UPON REQUEST. “Private Classes” are classes that include you and a group of your friends/colleagues who would like to attend a course together. You must receive written approval to confirm a private class. Contact MC for more information. When messaging us, please add that you are requesting details about a Private Class: momsdoula@mcdsonlinedoulas.com Title of the document PAYMENT OPTION 1 - Pay with a Debit or Credit Card (Visa, MasterCard or American Express Accepted)PAYMENT OPTION 1 - SELECT CLASS TYPE VIRTUAL - 1 CLASS - DOULA EDUCATION - Intro to Childbirth for Doulas VIRTUAL - 1 COURSE - DOULA WORKSHOP - DONA Birth Doula Training Workshop VIRTUAL - COMBINED CLASS SERIES - Intro Class & DONA Birth Doula Course IN-PERSON - 1 CLASS - DOULA EDUCATION - Intro to Childbirth for Doulas IN-PERSON - 1 COURSE - DOULA WORKSHOP - DONA Birth Doula Training Workshop IN-PERSON - COMBINED CLASS SERIES - Intro Class & DONA Birth Doula Course PAYMENT ARRANGEMENT: DEPOSIT - Applies to Intro & Workshop - MUST HAVE RECEIVED APPROVAL PAYMENT ARRANGEMENTS: You must receive written approval from MC to confirm a Payment Arrangement before selecting this option. Contact MC for more Information: momsdoula@mcdsonlinedoulas.com PAYMENT OPTION 1 - SELECT CLASS PRICE VIRTUAL - 1 CLASS - DOULA EDUCATION - Intro to Childbirth for Doulas VIRTUAL - 1 COURSE - DOULA WORKSHOP - DONA Birth Doula Training Workshop VIRTUAL - COMBINED CLASS SERIES - Intro Class & DONA Birth Doula Course IN-PERSON - 1 CLASS - DOULA EDUCATION - Intro to Childbirth for Doulas IN-PERSON - 1 COURSE - DOULA WORKSHOP - DONA Birth Doula Training Workshop IN-PERSON - COMBINED CLASS SERIES - Intro Class & DONA Birth Doula Course Title of the document IF YOU RECEIVED AUTHORIZATION OR WOULD LIKE TO REQUEST A PAYMENT ARRANGEMENT:(Reserved for those with a SEVERE Financial Need)DO NOT FILL OUT THIS REGISTRATION FORMCLICK HERE AND REQUEST PAYMENT ARRANGEMENT FORM FOR DOULA TRAINING Title of the document PAYMENT OPTION 1 - TOTAL AMOUNT TO BE CHARGED: PAYMENT OPTION 1 - ENTER CARD INFO - Visa, MasterCard or Amex Cardholder Name Card Details PAYING WITH CREDIT/DEBIT CARD: Payment Receipt will be sent to you separately. If you require an Invoice, please contact MC: momsdoula@mcdsonlinedoulas.com Title of the document Title of the document PAYMENT OPTION 2 - Pay with Zelle or Venmo PAYMENT OPTION 2 - PAYMENT APP - SELECT APP ZELLE PAYMENT APP VENMO PAYMENT APP CLICK HERE FOR RECIPIENT INFORMATIONZelle or Venmo Payments are made to Dr. Marlo Robinson (MCDS President & Directress)PAYMENT OPTION 2 - PAYMENT APP - SELECT CLASS PRICE $ 300.00 - VIRTUAL - 1 CLASS - DOULA EDUCATION - Intro to Childbirth for Doulas $ 600.00 - VIRTUAL - 1 COURSE - DOULA WORKSHOP - DONA Birth Doula Training Workshop $ 800.00 - VIRTUAL - COMBINED CLASS SERIES - Intro Class & DONA Birth Doula Course $ 300.00 - IN-PERSON - 1 CLASS - DOULA EDUCATION - Intro to Childbirth for Doulas $ 600.00 - IN-PERSON - 1 COURSE - DOULA WORKSHOP - DONA Birth Doula Training Workshop $ 800.00 - IN-PERSON - COMBINED CLASS SERIES - Intro Class & DONA Birth Doula Course $ 400.00 - PAYMENT ARRANGEMENT: DEPOSIT - Applies to Intro & Workshop - MUST HAVE RECEIVED APPROVAL PAYMENT OPTION 2 - CALCULATE & FILL IN THE TOTAL AMOUNT DUEPAYING WITH APP: Make your payment as soon as possible. Link to Access Virtual Classes, details for In-Person Classes or Class Confirmation will not be sent until payment is received. PRIVATE CLASSES: You must receive approval to confirm a private Class. Contact MC for more Information: momsdoula@mcdsonlinedoulas.com Title of the document Title of the document IF YOU RECEIVED AUTHORIZATION OR WOULD LIKE TO REQUEST A PAYMENT ARRANGEMENT:(Reserved for those with a SEVERE Financial Need)DO NOT FILL OUT THIS REGISTRATION FORMCLICK HERE AND REQUEST PAYMENT ARRANGEMENT FORM FOR DOULA TRAINING Title of the document CLASSES & DATES YOU WILL ATTEND CLICK HERE FOR OUR CALENDAR Some courses during the year will be split into multiple classes. Classes may include as many as 6 total classes. Contact MC for details and to confirm dates and times. Contact us at: momsdoula@mcdsonlinedoulas.comCLASS DATE 1:CLASS DATE 4:CLASS DATE 2:CLASS DATE 5:CLASS DATE 3:CLASS DATE 6:IN-PERSON LOCATIONS - Mother's Care has locations in Miami Beach, Florida, Pembroke Pines, Florida & Mars Hill, North Carolina. Please contact us for detailed location information. Upon Registering, you will be provided details on location, and other important information. (Exact Location/Address of Training will be provided to you when your Registration Form is Received)IN-PERSON CLASSES - We require a minimum of 4 registrants for IN-PERSON Training in our Miami, Pembroke Pines or Mars Hill, NC locations. If the minimum is not met, classes WILL convert to Virtual. You will be given the option to transfer into the converted Virtual Class or transfer into the next available In-person Class. PLEASE REVIEW THE REFUND CANCELATION & TRANSFER POLICY BELOW. Title of the document REFUND-CANCELLATION POLICY & TRANSFER OF SERVICES: ALL CLASSES ARE NON-REFUNDABLE - There are No Exceptions. While classes are non-refundable they are transferable. See below for details. WHAT IF I MISS A CLASS OR A WHOLE CLASS SERIES? If you are unable to attend a class or class series you are registered to (whether Virtual or In-person), you can request to be transferred into another class at a later time. You have 1 year from the date of your paid registration to be transferred into another class. If this time expires, you must register again. You are responsible for the entire payment. No refund or discounts will be issued. To request a transfer to another class, please contact us as soon as possible, in writing by email. TO CANCEL YOUR CLASS & REQUEST A TRANSFER INTO ANOTHER CLASS DATE: Email us at momsdoula@mcdsonlinedoulas.com. ARE THERE ANY OCCASIONS WHERE THE CLASS MAY NEED TO BE CANCELLED/RESCHEDULED? There may be an occasion where, due to a circumstance beyond our control, the class may have to be rescheduled. In the event your class must be rescheduled we will contact you as soon as it is possible. You will be contacted and offered the choice to join the next scheduled class date. As our Refund-Cancellation Policy states, there are refunds. Instead, MC has 1 year from the date of your paid registration to transfer you into another class but will make every attempt possible to reschedule you into the closest date available. IN-PERSON CLASS REGISTRANT MINIMUM - We require a minimum of 4 registrants for Trainings that occur in our Miami, FL location & 6 registrants for Trainings that occur in our Pembroke Pines, FL & Asheville, NC locations. If the minimum is not met, classes convert to a Virtual Class or Series. As our Refund-Cancellation Policy states, there are refunds or discounts. If you prefer not to attend the converted Virtual Class, you can ask to be transferred into the next available In-person class that occurs within 1 year from the date of your paid registration or attend a Virtual Class before this time expires.REFUND & CANCELLATION POLICY ACKNOWLEDGMENT:(Required) I have read and agree to the Refund & Cancellation Policy Title of the document WHAT HAPPENS AFTER I SUBMIT THIS FORM & SEND IN MY PAYMENT? (1) An automatic Confirmation and Thank You message will appear on your screen signaling that your Form was received and will be reviewed by our MC Administrative Staff. (2) A follow-up message will be generated and you will receive an emaill to the address you included on your form. (3) The Official Confirmation Message that includes specific details about your classes including a confirmation of the dates, times and locataion will be emailed along with a separate & Google Invitation. The Official Confirmation & Google Invite will be sent to you within 72 hours. (4) I PAID BY CREDIT/DEBIT CARD - Payment Receipt will be sent to you separately from your Credit/Debit Card Company. If you require an Invoice, please contact MC and request one: momsdoula@mcdsonlinedoulas.com (5) I PAID WITH A PAYMENT APP - (Zelle or Venmo) - Send your payment using the Recipient Info above as soon as possible. The Link to Access Virtual Classes or your Official Confirmation will not be sent until payment is received and confirmed. When your payment is made, a Payment Receipt will be sent to you separately from your App. If you have any questions, please contact momsdoula@mcdsonlinedoulas.com or call us at 954.433.CARE (2273) These forms are copyrighted and cannot be copied/used/reproduced without our authorization. Title of the document CAPTCHAPhoneThis field is for validation purposes and should be left unchanged.