Course Booking Form

Course Booking Form

Please fill in the form to book your place on a course. Please make payment on booking to secure your place. Payment details are at the end of the form. Please add your full name as the reference so we know who the payment is from. Thank you. 

Before filling in the form, please note the price of the course as you will need to know this. 

Please answer all questions.

Course Date

Which course are you applying for?

Baby Massage Baby Yoga 

Your Name (required)

Baby's name

Telephone

Your Email (required)

Baby's Date of Birth

Have you and baby had your 8 week postnatal check?
Yes No 

Do you or baby have any medical concerns? Please specify below or type None if s/he doesn't

Has baby had their immunisations?
Yes No 

What type of birth did you have ?

Does baby have any learning or physical needs? Please specify below or type No if s/he doesn't

Does your baby suffer with Colic, Reflux or Clicky Hips? Please specify below or type No if s/he doesn't

I take full responsibility for the health of my child and myself in the sessions and should there be any medical changes I will consult my instructor. I understand that I will be responsible for my child throughout the course.

I agree to the above 

Today's date

When you press send, it will automatically take you to Paypal where you can use your Paypal account or your debit or credit card to pay. You do not need a Paypal Account to do this. If you do not wish to pay via Paypal please click cancel and return and contact Sarah for other options.

 

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Powerful Deep Tissue and Trigger Point Therapy techniques are used to help relieve pain in Soft Tissue across the body.

Find out more how deep tissue massage can help you >>

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