Register your interest

To register your interest in participating, fill out the form below and click submit. Please make sure you include either a phone number or an email address that you can be contacted on.

To register please make sure you read the registration information before submitting the form.

In registering my interest, I confirm that I have read the registration information 

* Required field

Name *



Contact number



Contact email



Postcode *



Due date for your birth *



Is this your: *



Age range *



Name of the hospital where you intend to birth *



Name of your midwife or doctor (if known)



Have you experienced any complications you would like us to know about? *

If yes, please provide details



Do you have a request for a particular student? *

If so, who?



Do you have any questions or comments?