Become a Certified Birth Doula Birth Doula Training Registration & Payment Form Registration Form - DONA Birth Doula Training Workshop REGISTRATION FORM: DONA Birth Doula Training Workshop Visit Pricing Page and FAQ Page for detailed information. CLICK HERE for DATES & TIMES: 2024 DONA Birth Doula WorkshopYour 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 Title of the document PAYMENT OPTION 1 - Pay with a Debit or Credit Card (Visa, MasterCard or American Express Accepted)CLICK HERE for DATES & TIMES: 2024 DONA Birth Doula Workshop PAYMENT OPTION 1 - SELECT CLASS TYPE VIRTUAL Â Â - INTRO CLASS ONLY Â - DONA Introduction to Childbirth for Doulas Class VIRTUAL Â Â - DONA CLASS ONLY Â - DONA Birth Doula Training Workshop VIRTUAL Â Â - COMBINED COURSE - DONA Introduction to Childbirth Class & DONA Birth Doula Training Workshop IN PERSON - COMBINED COURSE - DONA Introduction to Childbirth Class & DONA Birth Doula Training Workshop IN-PERSON - VIRTUAL *HYBRID* Â - DONA Introduction to Childbirth Class & DONA Birth Doula Training Workshop PRIVATE INTRO & WORKSHOP - Additional Fee for Private Classes - MUST HAVE RECEIVED APPROVAL PAYMENT ARRANGEMENT: DEPOSIT - Applies to Intro & Workshop - MUST HAVE RECEIVED APPROVAL PRIVATE CLASSES: You must receive approval to confirm a private Class. Contact MC for more Information: momsdoula@mcdsonlinedoulas.com PAYMENT OPTION 1 - SELECT CLASS PRICE $ 250.00 - VIRTUAL - INTRO CLASS ONLY - DONA Introduction to Childbirth for Doulas Class $ 600.00 - VIRTUAL Â Â - DONA CLASS ONLY Â - DONA Birth Doula Training Workshop $ 700.00 - VIRTUAL Â Â - COMBINED COURSE - DONA Introduction to Childbirth Class & DONA Birth Doula Training Workshop $ 700.00 - IN PERSON - COMBINED COURSE - DONA Introduction to Childbirth Class & DONA Birth Doula Training Workshop $ 700.00 - IN-PERSON - VIRTUAL *HYBRID* Â - DONA Introduction to Childbirth Class & DONA Birth Doula Training Workshop $ 200.00 - PRIVATE INTRO & WORKSHOP - Additional Fee for Private Classes - MUST HAVE RECEIVED APPROVAL $ 350.00 - PAYMENT ARRANGEMENT: DEPOSIT - Applies to Intro & Workshop - MUST HAVE RECEIVED APPROVAL Title of the document FOR PAYMENT ARRANGEMENTS - Authorized Payment Arrangements (Reserved for those with a critical financial need) If you were approved for a Payment Arrangement, complete the section below: I received written authorization from MC for a Payment Arrangement. I understand that the 50% DEPOSIT is NON-REFUNDABLE. I understand that I will not receive a *Certificate of Attendance until the DEPOSIT is PAID IN FULL. I understand I must complete the PAYMENT ARRANGEMENT FORM for the REMAINING BALANCE PAYMENTS (see below to access Form). *The Certificate of Attendance is required to complete DONA Birth Doula Certification. DID YOU RECEIVE AUTHORIZATION FOR A PAYMENT ARRANGEMENT? CLICK HERE to access PAYMENT ARRANGEMENT FORM Title of the document PAYMENT OPTION 1 - Total Amount Charged $0.00 Title of the document 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, Cash App or Venmo PAYMENT OPTION 2 - PAYMENT APP - SELECT APP TYPE ZELLE APP - Connect to your Payment App CASH APP - Connect to your Payment App VENMO APP - Connect to your Payment App ZELLE RECIPIENT INFO: CASH APP RECIPIENT INFO: VENMO RECIPIENT INFO: Account Name: Marlo Robinson Account Name: Marlo Robinson Account Name: Marlo Robinson Phone Number: 305.979.2823 $CashTag: $mamadoula Venmo User Code: @Marlo-Robinson-6 WHO IS "MARLO ROBINSON"? Dr. Marlo Robinson is the Owner & President of MCDS and Lead DONA Birth Doula TrainerPAYMENT OPTION 2 - PAYMENT APP - SELECT CLASS PRICE $ 250.00 - VIRTUAL - INTRO CLASS ONLY - DONA Introduction to Childbirth for Doulas Class $ 600.00 - VIRTUAL - DONA CLASS ONLY - DONA Birth Doula Training Workshop $ 700.00 - VIRTUAL - COMBINED COURSE - DONA Introduction to Childbirth Class & DONA Birth Doula Training Workshop $ 700.00 - IN PERSON - COMBINED COURSE - DONA Introduction to Childbirth Class & DONA Birth Doula Training Workshop $ 700.00 - IN-PERSON - VIRTUAL *HYBRID* - DONA Introduction to Childbirth Class & DONA Birth Doula Training Workshop $ 200.00 - PRIVATE INTRO & WORKSHOP - Additional Fee for Private Classes - MUST HAVE RECEIVED APPROVAL $ 350.00 - PAYMENT ARRANGEMENT: DEPOSIT - Applies to Intro & Workshop - MUST HAVE RECEIVED APPROVAL PAYING WITH APP: Make your payment as soon as possible. Link to Access Classes 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 FOR PAYMENT ARRANGEMENTS - Authorized Payment Arrangements (Reserved for those with a critical financial need) If you were approved for a Payment Arrangement, complete the section below: I received written authorization from MC for a Payment Arrangement. I understand that the 50% DEPOSIT is NON-REFUNDABLE. I understand that I will not receive a *Certificate of Attendance until the DEPOSIT is PAID IN FULL. I understand I must complete the PAYMENT ARRANGEMENT FORM for the REMAINING BALANCE PAYMENTS (see below to access Form). *The Certificate of Attendance is required to complete DONA Birth Doula Certification. DID YOU RECEIVE AUTHORIZATION FOR A PAYMENT ARRANGEMENT? CLICK HERE to access PAYMENT ARRANGEMENT FORM Title of the document CLASSES & DATES YOU WILL ATTEND If you are unsure of the dates for classes, contact us at: momsdoula@mcdsonlinedoulas.com CLICK HERE for DATES & TIMES: 2024 DONA Birth Doula Workshop WRITE THE DATES YOU WILL ATTEND CLASSES: 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 minimum is not met, classes WILL convert to Virtual. You will be given the option to transfer into the coverted Virtual Class or transfer into the next available In-person Class. This option will be available within 1 year of your paid registration. PLEASE REVIEW THE REFUND CANCELLATION POLICY BELOW. IN-PERSON LOCATIONS - Mother's Care has locations in Miami, 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) 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, Cash App 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 CAPTCHACommentsThis field is for validation purposes and should be left unchanged.