Minor Consent Form
Minors are permitted to receive massage by Island Massage by Daniel.
• Minors (all clients under the age of 18 – unless otherwise emancipated) can
only receive massage with written parental/legal guardian consent.
• In collaboration with the consenting adult and child, the massage therapist will
assist in establishing goals for the session(s).
• For clients age 13 and under, the parent/guardian must always be present in
the treatment room.
• For clients age 14-17 if both client and parent/guardian are comfortable with the
child being in the session room by themselves, please initial here _____
• Otherwise, parent/guardian should be in the treatment room during each
session. Once a comfortable therapeutic relationship has been established and
the massage therapist, child and parent are comfortable the parent/legal
guardian does not have to be present in the room.
• Appropriate draping will be always used during the massage, only areas being
massaged are uncovered