Registration: Doula Training (Nurturely – September 2024) SMC Full Circle Doula Training Registration Registrant’s First Name * Registrant’s Last Name * ADDRESS Street Address * City * State * Postal Code * Phone Number * Email Address * Education Level * Please SelectSome high schoolHigh school graduate or equivalentTrade or vocational degreeSome collegeAssociate degreeBachelor's degreeGraduate or professional degree Ethnicity (Optional) Please SelectAfrican American or BlackAfrican ImmigrantAmerican Indian or Alaska NativeAsianLatino/Latina/LatinxNative Hawaiian or Other Pacific IslanderWhiteTwo or More RacesI'd rather not say. Have you trained as a doula with another program? * Yes No Please list the program(s) you have participated in. * In your own words, please tell us what you hope to gain from training as a SMC Full Circle Doula Birth Companion. * SOCIAL MEDIA PRESENCE Instagram Facebook LinkedIn MEDIA RELEASEAs a condition of registration and participation in this course, all students will be required to grant permission to the rights of their image, likeness and sound of their voice as recorded on audio or video tape without payment or any other consideration. Students understand that their image may be edited, copied, exhibited, published or distributed and waive the right to inspect or approve the finished product wherein their likeness appears; waive any right to royalties or other compensation arising or related to the use of their image or recording. Students will be required to sign a release which can be reviewed here.COURSE POLICIES1) I will attend all scheduled classes. The trainer has the discretion to decide if I am meeting participation requirements and receive a Certificate of Completion. Actively participate during class. 2) I will honor group agreements established on the first day of the training session. 3) I will keep all information shared in class confidential. Take the lesson, leave the stories. 4) I will not record any of the class. 5) I consent to SMC recording class sessions and understand that portions of the recordings may be used for educational, training, and promotional purposes.By clicking Register Now below, you agree to SMC’s Media Release and Course Policies above as well as SMC’s Privacy Policy and Terms of Use. I have also reviewed the Media Release that all students are required to sign prior to the start date of a course. Register Now If you are human, leave this field blank. Share this: Share on Facebook (Opens in new window) Facebook Share on X (Opens in new window) X
