Private Baby Massage Class
All information on this form will be kept confidential and is solely for my purpose in ensuring that your and your baby’s individual needs are met in class, and that strokes can be modified/omitted if necessary.

Please note: Once I have received your form I will email you to arrange a time (please allow 48-hours for a response). Payment details will be sent once a time is confirmed.   
If you have any questions please email me: thelittleconfidencecompany@gmail.com
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Which class would you like to book? *
Required
Your name and contact number *
Baby's name and DOB *
Preferred time for session/s *
Required
Emergency Contact name & number *
If booking with a partner, please provide their name
If booking with a friend please provide their name, contact number and email
Does your baby have any medical/health issues I should be aware of e.g. known allergies, hip dysplacia, cystic fibrosis etc. Please provide details if necessary, including any medication they are taking. *
Do you have any medical/health issues etc. I should be aware of? E.g back problems, mobility issues, anxiety, learning needs, etc. This information helps me make any necessary changes to ensure my teaching works for you. *
Do you have any religious, cultural or other requirements that I should be aware of? Please give details
Is there anything else you would like to share with me?
How did you hear about me? *
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PLEASE READ THE FOLLOWING AND TICK TO SHOW YOU AGREE & UNDERSTAND:  I understand that during classes I am 100% responsible for the safety and wellbeing of my own baby. I agree to inform my instructor BEFORE the workshop if anything changes in terms of mine or my baby's health. I will NOT attend this workshop if I have reason to supect that I or my baby has Covid (or any other illness).  *
Required
REFUND POLICY – Please read: If you cannot make a single class for some reason please try and provide at least 24hrs notice (I know this can be hard with babies) and I will do my best to fit you in at another mutually aprropriate time. However, if you have to cancel 2 classes in a row I am under no obligation to reschedule and you will only receive the remaining sessions. 

If for some reason you can no longer attend any of the classes after payment has been made, then a refund (less $10 for admin costs) will be offered up to 10 days before the start date. If less than 10 days’ notice, there is NO REFUND. If for any reason I need to cancel an entire series of classes, you will be offered a FULL REFUND or the option to roll over to a future series of classes.  If I need to cancel a single class then arrangements will be made to make up that class at a time that suits you.
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