Pure Rejuvenation Parent and Baby Registration Tree Babies.

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Please fill in this registration form for classes with Pure Rejuvenation

Where do we store data?
-Data from this form is stored in the Cloud or on an encrypted computer.

Who we share your data with?
-We do not share your data with anyone else, unless required to do so by law.

Why we need the information and how it is used?
-For insurance reasons it is essential to know who attended the sessions and the information is required to be kept up to 7 years.
-To provide you with information regarding the baby massage.
-To contact you via phone or email regarding to the Baby Massage Classes you are attending or relating to the assessment form.

Email *

COVID-19 Guidelines

This section is related to COVID-19 and the questions we are required to ask according to government guidlines.

The priority at Pure Rejuvenation is to keep you, your family and the venue as safe as possible whilst classes return. In order to achieve this, preventative measures have been put into place in line with government guidelines and as part of those guidelines, I am required to ask you some questions regarding COVID-19. This information is kept completely confidential unless legally bound to release it. Please tick the box below to say that you understand this statement * *

I understand

Have you been in close contact with anyone confirmed to have contracted COVID-19 in the last 14 days? * *

Yes

Have you been in close contact with anyone confirmed to have contracted COVID-19 in the last 14 days? * *

Yes

Are you awaiting the result of a COVID-19 test or have tested positive for COVID-19 in the last 7 days? *

Yes

I am obliged to notify Track & Trace if any symptoms arise among me or my family. If I am contacted by Track & Trace, I am legally obliged to inform them of my contact details. * *

I understand

I understand the contagious nature of COVID-19 and that government guidelines still encourage social distancing. I voluntarily seek services from Pure Rejuvenation and acknowledge that this increases my risk of exposure. I acknowledge that I must comply with any safety guidelines put in place whilst in classes to reduce this risk of exposure. I understand that all this information is true and accurate and I take full responsibility for my baby during classes. By dating and submitting this form please accept this as my signature * *

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