Booking Form

We would like to attend a BirthVenture weekend on:………….……...…*residential/non-residential (1st choice)

or ..................................................................................................*residential/non-residential (2nd choice)
(*Please delete as appropriate)

My name is:………………………………............................………………D.O.B .………………….…….

My occupation is:……………………….................……………......…..………………….………..…..…..

I am …....... ft and …......... inches tall (height needed for correct size birth ball)

My partner’s name is: …………………..............………….....…Our baby’s due date is: . …….………...

Address:……………………………………..............……….................……………………………..……

...................................................................................................Postcode:…………………………..

Telephone (home/mobile/work) ……………….............…………… Email…………….………………….…

Do either of you have any specific dietary requirements that we need to consider? Yes/No

If yes, please elaborate…………………………….............…………….……………………..........………

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The cost of the course, per couple, is £425 for a residential weekend, or £325 for non-residential.
(For details of what is included in the course price, please see website)

If you would like to book a place, please call 0870 879 3238 or email antenatalcourses@birthventure.co.uk to check availability, and then send this completed form along with a deposit of £150 to secure your place to:

BirthVenture
Caradoc, Plantation Road
Leighton Buzzard
Beds LU7 3HT

Alternatively you may pay by credit/debit card by clicking the appropriate button next to your choice of course on the course dates page or via BACS transfer. Please call for our bank details.

If paying by cheque, please complete the following:

I enclose:

• £150 deposit [ ] £425 residential course fee [ ] £325 non-residential course fee [ ]
• Saturday Evening 3 course dinner in Astons restaurant @ £29.50 per person [ ]
• Additional nights accommodation £125* (normally £150) per couple [ ] for the Friday night
• I would like to purchase a birth ball @ £20 [ ] (size 65cm[ ]/75cm[ ])
• I would like to buy a TENS machine @ £50 [ ] (machine collected when course attended)
• I would like to hire a TENS machine @ £29.50 [ ] (machine posted to you at 37 weeks)

Total amount enclosed £.................. Amount outstanding (due 28 days prior to course) £............

Cheques should be made payable to BirthVenture

* Discounted rate only available when booking through BirthVenture.

Terms and Conditions

Cheque Payments:

Your £150 deposit will reserve your place for you on your chosen course (subject to availability)
The balance must be received 28 days prior to the course start date. You may cancel up to 28 days prior to the course start date and your £150 deposit will be refunded. If you cancel within 28 days of the start date the deposit is non-refundable.

Credit/Debit card payments online:

If paying online by credit/debit card the full amount is due at time of booking. You will then be required to complete and return the booking form and pre-course questionnaire. As places are limited, the course you require may be full so your booking is not confirmed until you receive a confirmation letter from BirthVenture.. If your chosen course is full an alternative date will be offered, but if that is not suitable a full refund will be made.

Additional items such as birth ball or TENS purchase can be made either by cheque in advance or by cheque/cash during the course but please do let us know if you wish to purchase a TENS so a machine is available for you. TENS hire forms can be mailed out to you before the course or collected for completion during the weekend and machines are mailed directly to you at 37 weeks.

I the undersigned have read and agree to BirthVenture’s Terms and Conditions.

Signed………………………………………………………………..………… Date ……...............…..

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BirthVenture Pre-Course Questionnaire

Thank you for booking on a BirthVenture Birth and Beyond Weekend!

So we can ensure that the course is designed to meet your needs, please take the time to fill in this form and return to us with your completed booking form.

Expectant Mothers……..
Is there anything about your pre-pregnancy medical history your teacher should be aware of?
(e.g. history of high blood pressure, heart problems, pre-existing medical condition)

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Is there anything about your pregnancy that you feel your teacher should know?

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How many babies are you expecting…………… Is this your first baby? ..................................................

….. and Expectant Father’s/birth partner (please complete together)

What are you hoping to learn on a BirthVenture weekend? Please tick as many boxes as apply.

Is there anything not listed above that you are really hoping is covered?

…………………………………......................................................................................................

Do you have any concerns or worries about the course?

…………………………………………………… ..............................................................................

Have you chosen where you hope to have your baby yet? Yes [ ] No [ ]

If yes, please state where

………………………………………………………………………………………… ..............................

Is there anything else you want to tell us?

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And finally, where did you hear about BirthVenture? (If search engine, please say what you searched for)

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Thank you! We look forward to meeting you!