Registration form – HypnoBirthing®

This post is also available in: Deutsch (German)

Course*:

First name*:

Family name*:

Street / no.

Postcode / town

Telephone*:

E-mail*:

Health insurance*:

Date of birth*:

Due date (expected date of birth)*:

* Please fill out the marked fields

Payment
After receiving the booking confirmation (email) and at latest 2 weeks before course begin I will:

transfer the course costs to the following account number:

recipient: Vesna Lemm
Subject: Hypnobirthing
IBAN: DE63 3006 0601 0207 0269 00
BIC: DAAEDEDDXXX

If the payment is not made on time, the course spot will be given to next person on the waiting list.

Please notice: If you can't make it to your appointment please notify us 12 hours in advance (info@berliner-akupunkturpraxis.de).

If you miss an appointment without cancelling, the appointment cannot be repeated.

Comment / additional information:

I agree to the processing and the forwarding of the information I entered above. I can withdraw my consent at any time with immediate effect.

Praxis Lemm