Registration for Blossom
Classes/Groups/Training, etc.
Note:
This page is best viewed with Internet Explorer.
To register for
a Blossom class:
1. Fill out the information on screen
2. Print the page.
3. Mail this page, along with your check payable to Blossom Birth Services
to:
Blossom
Birth
299 S. California Ave Suite 120
Palo Alto, CA 94306
Please
note:
- Before you send in your registration, check the classes
page to make sure your class date is still open. If a class is full
that you are interested in taking, you are welcome to call to be put on
a waiting list. Thank you.
- Registration for classes is based on a first come, first serve basis.
We are unfortunately not able to accept credit cards at this time, so
please send in a check as soon as you have made your class selections.
Payment
policy: If for any reason your check does not clear, a $20 processing
fee will be added to your bill.
Contact
Information
Names
(mother/partner):
Address
City,
Zip:
, CA
Phone
(Home/Work):
Home
(
)
Work
(
)
Baby's
Due/Birth Date:
Month
Day
Email
Address:
May
we include you in our mailings?
Yes
No
Can
we confirm your classes via e-mail?
Yes
No
From
whom did you hear about us?
(Please tell us the person's name so we can thank them!)
Interested
in volunteering at Blossom?
Please print and fill out this volunteer
form and mail it with your registration.
Class Selection
Class
#1:
Begins
on:
Month
Day
Fee: $
Class
#2:
Begins
on:
Month
Day
Fee: $
Class
#3:
Begins
on:
Month
Day
Fee: $
Class
#4:
Begins
on:
Month
Day
Fee: $
Note:
If you are registering for more than 4 classes, print a separate registration
form.
Refunds/Cancellations
Blossom classes are known for expert instructors and small class sizes. Please help us keep classes affordable by selecting your course dates carefully.
If you must switch or cancel, contact us at least three weeks before the course date for full credit or refund.
If you contact us between one and three weeks before the course date, you will receive credit (minus $15 fee) toward another Blossom class(es) to be used within one year.
If you must cancel within one week, your fees will be contributed to our scholarship fund. We will be glad to send you a letter for tax purposes acknowledging your donation.
I have read
and understand the Blossom cancellation policy as listed above.
$
Please note:
Starting
in January 2003 Blossom is offering a discount education package. You will
receive a 10% discount if you register for the following classes: Blossom
4-week Series, Blossom Weekend Intensive, Breastfeeding Basics, Child Care and Surviving the first
6 weeks. With the discount this package comes to $390. Please calculate
the discount in your total.
Additional
Contributions
Blossom
is a nonprofit organization created to centralize and expand the
resources available to expectant and new moms and families. Class
fees cover only a portion of Blossom's expenses. With your
kind support, Blossom Birth Services will continue to be available
for individuals and families in need of resources, information,
encouragement, and support. As with any nonprofit, your donation
is fully tax-deductible. If you would, please make out
a separate check for your donation amount, to help our staff
with processing.
Enclosed
is an additional check for the tax-deductible amount of:
$
To
be designated for:
General Fund
For Blossom to use in its areas of greatest need.
Scholarship
Fund
Help Blossom provide services to those with limited financial resources.