MooBorn Baby Massage

Parent/Legal Guardian Contact Name

First NameLast Name

Contact Telephone Number

Email

example@example.com

Baby's Name

First NameLast Name (Optional)

Baby's Date Of Birth

Has your child had their 8 week Dr check up?

Does your child settle well?

Does your child have any skin infections or broken skin?

Does your child have any known allergies?

Does your child have any problems with their hips, heart or stomach?

Has your child had any surgery since birth?

Does your child have any convulsions or neurological problems?

Does your child suffer from wind, colic, or digestive problems?

Does your child suffer from any respiratory problems?

Is your child currently on any medication?

Are there any reasons why medical approval may be required?

Any additional info (Optional)

Course you're booking-

Your Course Will Include the Following Items-

A bottle of Natural oil
A fluffy hooded towel
Step by step handbook

This course will include refreshments after class and the opportunity to meet and socialise with other parents.

Massage Consent

Photography Consent

Please Note- Photographs may be taken during class but will not be used by Moo Music if they feature yourself or your child if consent not given.

Would you like to be kept informed about special offers and Moo Music sessions?

Shortly after this form has been completed you will recieve payment details via the email address you have provided. This will then lock in and reserve your place in the course.