Baby Massage/Baby Yoga and Learn Stretch and Play Parent and Baby Registration Form

Name (Mother/Father)

First NameLast Name

Babies Name

First NameLast Name

Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Phone Number

Area CodePhone Number

Email

example@example.com

Date of Birth of Baby:

*Note: baby massage courses are suitable for babies aged 8 weeks to pre crawling - Baby Yoga is suitable from 10 weeks to around 14months and Learn Stretch and Play classes are suitable from 4/6months to around 3 years old

Course Venue (please tick)

HOME ZOOM VIRTUAL ONLINE CLASSES

Please choose which course you would like to join

1:1 - ZOOM baby massage course - 3 sessions £35 dates to be confirmed on booking.

Would you prefer to receive info by email / text or post?

Name of Emergency Contact

First NameLast Name

Phone Number of Emergency Contact

Area CodePhone Number

Where did you hear about my courses:

Have you and your baby had your 6 week postnatal check up?

Did your medical professional have any concerns? If so, what? If you are under a medical team, please ensure consent is given before practicing Baby Massage or Yoga

Will your baby have immunisations within 24 hours of a baby massage session? If yes, please refer to the safety guidelines below.

Do you or your baby have any allergies?

For Baby Yoga / Learn Stretch and Play classes, is there anything that would prevent you from doing gentle stretches with your baby. If yes, please explain:

Is there anything about the birth of your baby, and how you experienced it that might be useful to know?

Does your baby have any health conditions (including colic, clicky hips, reflux etc...?) Please give full details below. If you are under a medical team, please ensure consent is given before practicing Baby Massage or Yoga

Safety guidelines

Please read these guidelines carefully before you attend your first class.

Parents work with their own baby.

When practicing with your baby, never rush or force anything. If you feel stressed or tense, just take a break and come back to the practice later. Always ensure that you feel safe, secure and confident with the way you are holding or working with your baby. Never do anything that you do not feel comfortable with.

If your baby is unwell, it is best not to attend the massage class. If your baby is crying excessively and cannot be comforted, he/she may be ill. Never practice on a distressed baby, or if your baby is limp, pale, has a temperature, or any difficulties breathing. Please seek appropriate medical help.
It is not recommended to practice within 24 hours of your baby’s immunisations. You are still welcome however to come along to the session and you can either sit and watch and then practice at home or you can join in and practice the strokes on a doll instead.

Disclaimer
Please sign the following disclaimer.

I have read the above safety guidelines and will ensure that I adhere to them.

I take full responsibility for myself and my baby, and for everything that happens to me and my baby in relation to the Baby Massage class.

If I have any doubts, I will seek the advice of my medical professional before proceeding with Baby Massage classes.

I will keep the Baby Massage Teacher informed of any health issues that arise over the course of the classes, both for me and my baby.

I understand that refunds are not possible for missed classes.

I understand that payment is due IN FULL at the time of booking to confirm my place as spaces are limited and once payment has been made, no refunds will be given.

I agree to the above disclaimer:

CONSENT TO USE OF PHOTOGRAPHS
As you know it is really helpful for other parents who are looking to book a course to be able to see pictures on my website / facebook page of what happens in a class. There is absolutely no pressure to agree but if you would be happy to consent to me taking pictures, please would you be kind enough to complete the details below. Just to clarify - the pictures will only be to show some of the massage moves we do or a group shot and I can show you the pictures as I take them for you to approve before use if you prefer.

If you confirm you are happy, any pictures taken will be used purely on Patta Cake Baby Massage's Facebook page, for Publicity and on the Website. I understand that should Patta Cake Baby Massage want to use them for anything other than the above, I will be contacted before.

I am happy for photos to be taken of me and my baby during class:

VIRTUAL ONLINE CLASSES

All online classes are provided via Zoom. If have booked a group session, you will be able to see other parents who are part of the group and will be able to interact with both myself and others in the group. For insurance purposes, as your instructor I do need to be able to see the strokes you are doing to check that you are doing them correctly so I do require you to have your video on. However if you have any issues or queries regarding this, please contact me direct.

Please confirm you understand how the online Zoom sessions work:

I would like to sign up to Patta Cake Baby Massage and Yogas newsletter to receive helpful information to support me and my baby as well as find out more about additional classes and courses.

Date signed

Please sign below to agree to all of the above and confirm you have provided the answers to the questions to the best of your knowledge:

Payment is due with your booking form to confirm your space by BACS:

Mrs N McCutcheon

Ac: 10745164

sort: 11-14-64

Thank you for completing this form. Please keep a copy for your information. The information you give is confidential. Thank you.

Baby Massage/Baby Yoga and Learn Stretch and Play Parent and Baby Registration Form

The birth of your baby