I understand that attending this training is a major step towards becoming certified with CAPPA. If I choose to pursue certification, there are additional requirements and fees that can be found at www.cappa.net. I understand that my tuition is required to hold my seat in this training. There are no refunds due to student cancelation, but I may receive full credit toward another training if I cancel by written notification at least 30 days prior. If the training is cancelled due to low enrollment, I will be notified at least a week in advance and I will be able to choose a complete refund or credit towards another training. I understand I should not make non-refundable travel arrangements unless I have received confirmation from CAPPA Faculty that the training is confirmed.

I agree to allow CAPPA Faculty 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 CAPPA Faculty and CAPPA 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 CAPPA or CAPPA Faculty.
I may not reproduce, publish, or distribute any materials in the training manual.
I may not reproduce, publish, or distribute any certification materials, other than for the purpose of fulfilling my certification requirements (i.e. copying the evaluation forms for my clients to fill out).
I may not reproduce, publish, photograph, share, email, or distribute any materials in the training hand outs or manual other than for the purpose of using them for my personal business as a labor doula or childbirth educator.
I may take photographs of CAPPA Faculty and the participants ONLY with the express permission of CAPPA Faculty and the participants. I may not use these photographs for any purpose other than personal use. No photographs from the training may be distributed via email, posted to my website, Facebook account, or other online media, nor may they be used for any advertising purpose, nor sold or transferred to any other party.
Babies/children are not permitted at training. Nursing babies are welcome during lunch. Off-site childcare arrangements are the sole responsibility of the trainee.
Certificate of training completion is given only if the entire training is attended, the Pre-Workshop Study Guide is completed, and training fees are paid in full.
I verify that all of the information given in this application is true. I further affirm that by filling out and returning this intake form via email, I agree to the terms as given herein, in lieu of physical signature.