I hereby state that I am enrolling in the HypnoBirthing® classes of my own free will. I understand that this program is designed to teach me to use my own natural abilities to bring my mind and body into a state of relaxation. I understand that these classes are not intended to represent medical advice nor medical procedures. I will seek advice from my medical doctor, midwives etc. should any medical questions arise regarding my pregnancy and birth.
 
I, therefore, agree that I will in no way hold the instructor of the HypnoBirthing® classes in Arizona or the HypnoBirthing® Institute responsible for any complications that could arise as a result of my pregnancy, labor or delivery of my baby. I agree that neither I or any member of my family will make a claim or initiate a suit against the above named parties now or any time in the future.

I agree to abide by HypnoBirthing® Arizona's appointment cancellation policy, except if actively birthing. I will give 24 hours notice by phone or email for scheduled conflicts. Minimum of 4 hours notice by phone for same day unplanned illness, and emergencies. I agree to pay a $45.00 cancellation fee (for private sessions only) per incident, for failure to follow these procedures. If you are attending a group class, you are welcome to join any exsiting class for make-up at no cost however, I agree to pay a    
$45.00 private rescheduling fee if none is available.


Signature:_____________________________ Date:_______________
                         Sign day of first class 


 1. First fill out agreement/enrollment form with the choice of
     payment indicated within the form.
 2. Then press submit.
 3. If paying by PayPal proceed to the bottom of the registration form, select  
     your payment and follow directions given by PayPal.
4. If mailing payment for deposit, balance or full payment Mail to: 

Lucy Schwill, 708 W. Citrus Way,Chandler Az. 85248 

Balance Payments are due First Class

            Enrollment Form: