Teddy Bear University - Registration

Welcome to Teddy Bear University!

A pre- and post-natal education program sponsored by Parkwest Medical Center and Fort Sanders Regional Medical Center.

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Registration Information

Mother-To-Be:

Name (last/first/MI) _______________________________________
Address _____________________________________________________
City/State/Zip ______________________________________________
Home Phone ________________ Work Phone __________________
Age ________
Due Date ______________
Name of Physician ________________

Father-To-Be or Support Person:

Name (last/first/MI) ________________________________________

I will be delivering at (check one)
___ Fort Sanders Regional Medical Center
___ Parkwest Medical Center

I would be interested in touring the facility
___ Yes
___ No

Class Registration

Class	Fees	Preferred Month
Pregnancy and Childbirth (5-week series)	$60	________________
Sunday Series	$60	________________
Super Saturday Class	$60	________________
Breastfeeding Class (textbook included)	$25	________________
CPR (cost per person)	$20	________________
Breathing and Relaxation	$25	________________
Sibling Class (cost per child)	$10	________________
Grandparent Class	$10/person or $15/couple	________________
Infant & Prenatal Partner Massage (cost per couple)	$30	________________
Marvelous Multiples	$60	________________
One-Time Registration Fee	$5
Total	______

Please mail your registration form and a check or money order, payable to Teddy Bear University, to:
Teddy Bear University
1921 Topside Rd., Suite 201A
Louisville, TN 37777

A confirmation card, outlining the dates and times of your classes, will be sent to you upon receipt of your registration form and fees.

Scholarships are available for those with documented financial need.