Expectant Parents'
Registration Form

To register for any of our classes, complete and mail this form with your check made payable to Saint Mary's Hospital Foundation. Please be sure to write on the outside of the envelope "Expectant Parents' Class", note the class name and date of each class or series you want to attend on this form and on your check.

Mail to:

Saint Mary's Hospital, WIC
Expectant Parents' Program
56 Franklin Street
Waterbury, CT 06706

A confirmation letter will be sent to you after your registration is received.
Names:
Address:
City:
State:
Zip:
Phone (Day):
Phone (Eve):
E-mail:
Due Date:
Physician/Midwife:
  The Expectant Parents' Childbirth Program fee of $175, includes the Childbirth Preparation class, Healthy Start class, Infant Car Seat class and Breastfeeding class.
Class &
Class Date:
 Expectant Parents Program - $175
  Healthy Start Class - $35
*Free with Expectant Parents Program
  Infant Car Seat Safety Class - $35
*Free with Expectant Parents Program
 

Breastfeeding Class - $35
*Free with Expectant Parents Program
  Sibling Preparation Class - $20
   Total Pregnancy Fitness™
Dancing through Pregnancy©
Fee $72 for Month (2 Free Classes)
or $12 drop-in
  Parent-Infant Massage Class - $100
 
Sibling Name: Age:
Sibling Name: Age:
 

*Saint Mary's Hospital reserves the right to cancel any class that does not fulfill the minimum class enrollment and to close classes when the maximum enrollment is met. Should this occur, we will make every effort to accommodate you in another class.

If registering for a class that is 3 weeks or less away, please call to register @ (203) 709-3105. Class fee is due prior to date of class.