2020 Professional Doula Program Training Workshops Register for your alumni spot at one of the 2020 trainings. 1Terms & Conditions2About You3Birth Experience4Professional Experience5Payment By submitting this registration, you agree to the following Terms & Conditions: I agree to the following cancellation policy: If Rocky Mountain Doula cancels the workshop, students have the option of receiving a full refund or transferring to another workshop taught by Rocky Mountain Doula. All other cancellations will be charged a $75.00 processing fee. If the cancellation is made within three weeks of the workshop, no refund will be given. Cancellations prior to training workshop have the option of having payment applied to a training workshop given by Rocky Mountain Doula within 12 months. Only ONE transfer of registration is permitted. There is a $75.00 fee for registration transfer. No-shows are not eligible for registration transfer. If applicant does not attend a workshop within 12 months, all fees are forfeited. I understand I should not make non-refundable travel arrangements unless I have received confirmation from Rocky Mountain Doula that the training workshop is confirmed. In the event of hazardous weather, “act of God”, or any other travel issues making it impossible for Rocky Mountain Doula to hold the workshop, a makeup option will be made available. Rocky Mountain Doula is not responsible for any travel expenses students may incur. I agree to allow Rocky Mountain Doula to do the following: Publish my name, phone number, and email address for the doula trainee class list & referral list. Take photographs of the training which may include me, as well as allow Rocky Mountain Doula to use these photographs for promotional purposes online and in print. Use quotes from my training evaluations (which I may fill out anonymously) for promotional purposes online and in print. I agree to the following policies: I understand that I may not record the training workshop (audio or video). I understand that I may not photograph any PowerPoint slides, training materials, certificates of completion, or any other intellectual property belonging to Rocky Mountain Doula. I may not reproduce, publish, or distribute any materials in the training manual. I may not reproduce, publish, photograph, share, email, or distribute any materials in the training handouts or manual other than for the purpose of using them for my personal business as a labor doula. I may take photographs of the instructor and the participants ONLY with their express permission. I may not use these photographs for any purpose other than personal use. They may not be used for any advertising purpose, nor sold or transferred to any other party without the express permission of the parties in the photograph. Babies/children are not permitted at training. Nursing babies are welcome during lunch. Off-site childcare arrangements are the sole responsibility of the trainee. I understand that the instructor and Rocky Mountain Doula do not assume any liability for adverse reactions to foods consumed or anything one may come into contact with while at the training or during any activity you may attend whether inside or outside the training. I understand that I will receive an email confirmation from Rocky Mountain Doula within 48 hours of submitting this form. If I do not receive that confirmation, I will contact Rocky Mountain Doula at firstname.lastname@example.org to ensure that registration was received. I understand that I am not registered for this workshop until I have completed this registration AND the payment for the workshop fee has been received by Rocky Mountain Doula. I understand that I must be at least 18 years old to take a Rocky Mountain Doula Workshop. I verify that all of the information given in this application is true. I further affirm that my electronic signature is in lieu of my physical signature.Please sign your name below, indicating that you agree with the terms and conditions.* Reset signature Signature locked. Reset to sign again Name* First Last Age* Email* Phone Number*Address* Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Number of Births Attended (excluding your own):* Please indicate how many of each birth you have attended (an estimate is fine):Vaginal birth, C-Sections, VBAC, Unmedicated, Medicated, Hospital, Birth Center, HomeHave you experienced or witnessed a traumatic birth?* Yes No Please briefly describe:*Please describe what steps you have taken to process and heal from the trauma:* Do you work for a doula program?* Yes No Which one:* Are you a childbirth educator?* Yes No Organization:* Are you a lactation consultant, LLL leader, or do you teach breastfeeding classes?* Yes No Please specify:*Would you characterize your learning style as primarily:* Visual Auditory Kinesthetic Rocky Mountain Doula Workshop*May 16-17 in DenverTotal $0.00 What will you learn at a Doula Training? About the Workshop Get the most out of Doula Training Prepare for Training What students say about training with Ana Testimonials Join us for a Doula Workshop Register Today!