14.11.2014 Views

The Center for Women, Children, and Family ... - Valley Hospital

The Center for Women, Children, and Family ... - Valley Hospital

The Center for Women, Children, and Family ... - Valley Hospital

SHOW MORE
SHOW LESS

You also want an ePaper? Increase the reach of your titles

YUMPU automatically turns print PDFs into web optimized ePapers that Google loves.

REGISTRATION FORM<br />

PRICE<br />

<strong>The</strong> Ultimate Birthing Experience (Lamaze)<br />

Weekdays (5 – 2 hr. classes) or (4 – 2 1 /2 hr. classes) $ 200<br />

Weekend (2 – 5 hr. classes) $ 200<br />

Refresher (3 hrs.) $ 50<br />

Preparing <strong>for</strong> Parenthood<br />

Marvelous Multiples (3 – 2 1 /2 hr. classes) $ 200<br />

Breastfeeding Basics (3 hrs.) $ 50<br />

Newborn Care (3 hrs.) $ 50<br />

Dads On Duty - No Moms Allowed (2 hrs.) $ 40<br />

Gr<strong>and</strong>parents’ Class (3 hrs.) $ 45<br />

Infant <strong>and</strong> Child Safety (2 1 /2 hrs.) $ 40<br />

Pets <strong>and</strong> Babies (2 hrs.) $ 50<br />

<strong>The</strong> Happiest Baby On the Block (2 hrs.) $ 55<br />

Sibling Preparation 3-7 yrs. (1 1 /2 hrs.) $ 40<br />

Babysitters’ Preparation (2 hrs.) $ 35<br />

Inner Visions $ 150<br />

Yoga Classes<br />

Prenatal Yoga (5 – 1 hr. classes) $ 100<br />

Baby <strong>and</strong> Me Yoga (5 – 1 hr. classes) $ 100<br />

Toddler Yoga (5 – 1 hr. classes) $ 100<br />

<strong>Women</strong>’s Health Yoga (5 – 1 hr. classes) $ 100<br />

eLearning<br />

St<strong>and</strong>-alone class $200<br />

Taken with the Ultimate Birthing Experience $ 50<br />

Special Programs<br />

What is Cord Blood Banking $ 10<br />

Date<br />

<strong>Family</strong> <strong>and</strong> Relationship Workshops<br />

Achieving Your Goals $ 35<br />

Being Fearless vs. Fearful $ 35<br />

How to Make A Difference In the World $ 35<br />

Communication Techniques <strong>for</strong><br />

Middle/High School Students $ 35<br />

Girls On the Go $ 35<br />

Dialoguing With Your Toddler $ 35<br />

Dialoguing With Your Teenager In A Digital Age $ 35<br />

Inner Strength Tools $ 35<br />

Birth, Baby & Beyond - Networking <strong>and</strong> Socializing<br />

Check box <strong>for</strong> selected classes Fee: $20 per person unless otherwise noted*<br />

❑ Create Wellness –<br />

❑ Picky Eaters<br />

It’s More Than Genetics<br />

❑ Prenatal Yoga On the Beach*(free)<br />

❑ Babyfest at Whole Foods*(free) ❑ Financial Planning <strong>for</strong> Parents<br />

❑ Baby Steps to Re-enter<br />

❑ Health <strong>and</strong> Delicious<br />

the Work Force<br />

Real Food Snacks<br />

❑ Breast Health <strong>and</strong> Your Bra ❑ One Pot Healthy Meals<br />

❑ Baby ER<br />

❑ Two Angry Moms Screening*($5)<br />

❑ Raising A Green Baby<br />

❑ Sleep Training<br />

❑ To Immunize or Not to Immunize ❑ Growing Healthy Kids<br />

❑ Baby Sign Language<br />

❑ Stimulating Your Baby’s Brain<br />

<strong>and</strong> Developmental Stages<br />

Through Music <strong>and</strong> Foreign Language<br />

❑ Baby Proofing Your Marriage ❑ Shopping <strong>for</strong> the Holidays<br />

❑ Baby Photography <strong>and</strong> Modeling ❑ New Beginnings<br />

❑ Positive Parenting<br />

❑ Healthy Eating Over the Holidays<br />

TOTAL ENCLOSED: $<br />

Name:_______________________________________________________________________________________________<br />

Address:_____________________________________________________________________________________________<br />

________________________________________________________________________________ Zip: ____________________<br />

Work Telephone: ( )________________ Home Telephone: ( )___________________Cell Phone: ( ) ________________________<br />

Dr.:_______________________________ Due Date: __________________Email address: ______________________________________<br />

Name on credit card:____________________________________________________________________________________________________<br />

Card Number: _________________________________________________________ Exp. Date: ______________ Amount Charged: ___________<br />

Card Billing Address:____________________________________________________________________________________________________<br />

Signature ____________________________________________________________________________________________________________<br />

Any questions, please email us at familyeducation@valleyhealth.com.<br />

Mail this <strong>for</strong>m with your check, payable to:<br />

<strong>The</strong> <strong>Valley</strong> <strong>Hospital</strong>, Attn: <strong>Family</strong> Education, 15 Essex Road, Suite 202, Paramus, NJ 07652<br />

Or you may pay by credit card by faxing this <strong>for</strong>m to 201-291-6487. To register by phone, please call 201-291-6151.<br />

www.valleyhealth.com/familyeducation

Hooray! Your file is uploaded and ready to be published.

Saved successfully!

Ooh no, something went wrong!