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Reiki for Kids! Consent and Registration Form (ages 5-10)
When: Saturday, February 19th, 9 am - 12 pm
Event Address: 345 Main Street, Laurel, MD 20763
Questions/comments: 443-766-0894 or
jessica@gentlehandsreiki.com
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Email
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Your email
Your Child's Name
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Your answer
Your Name
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Your answer
Your Email Address
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Your answer
Primary Phone Number
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Your answer
Street Address
Your answer
Emergency Contact Name
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Your answer
Emergency Contact Phone Number
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Your answer
Are there any custody issues we should be aware of?
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No
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Photo Release: I give permission for my child's likeness to be possibly be shared on social media or placed in online advertising.
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No
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I understand that my child will be learning Reiki, a mode of channeling energy based in spiritual practice. I understand my child will not be engaging in specific religious practice. I give consent for my minor child to attend the workshop. (Please initial below.)
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I understand that the cost of this workshop is $99 and agree to pay in full upon registration. (Please initial below. Payment plans may be negotiated and financial aid is available if necessary -- contact me at 443-766-0894 to inquire.)
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I understand that filling out this form is only Step 1 of registration, and that my child's registration is not complete until payment has been submitted and received - instructions provided on next page. (Please initial)
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