Birmingham Central West BabyBeats Parent and Baby Registration Form

BabyBeats Parent and Baby Registration Form

Full Name

Baby's Name

Baby's Birth Date

Date

Date of first session

Date

Contact Number

Emergency Contact Number

How do you hear about us?

Have you and your baby had your 6 week postnatal check?

YesNo

Did your GP or Midwife have any concerns?

YesNoIf yes, please specify

Do you or your baby have any allergies?

YesNoIf yes, please specify

Do you know of any reason why you should not participate in a programme of physical activity?

YesNoIf yes, please specify

Is there anything about the birth of your baby that might be useful to know before commencing BabyBeats? e.g. c-section

YesNoIf yes, please specify

Do you or your baby have any health conditions such as colic, reflux, hip dysplasia, engorgement, injuries etc. that we need to be aware of before commencing classes?

YesNoIf yes, please specify

We would love to send you information on up and coming classes and events from BabyBeats by email. We will always treat your personal information with care and never sell them to other companies.

example@example.com

Yes please, keep me in the loop!

Please note in a BabyBeats class parents must always work with their own baby; at no point will a teacher demonstrate with your baby. During BabyBeats we aim to give you and your baby a calm and effective class. To achieve this, we ask that you never force your baby during any exercise, position or stretch. If you are unsure about any part of the class, please speak to your teacher.

We ask that you never perform any move that you are not comfortable with. Please ask your teacher for an alternative if you do not feel confident or happy.

At BabyBeats Birmingham Central West, we ask you to bring along your own oil or cream to massage your baby. We recommend the use of natural sunflower oil. Reactions to the oil are highly unlikely. Whichever oil or cream you wish to bring, we ask you complete a patch test on your baby at least 24 hours before attending your first class. This is done by placing a small amount of oil on the inside of your baby's wrist. Although highly unlikely you are looking for redness, raised area, hives, itchiness to the area or any other signs of an allergic reaction.

If you feel your child is not well, it is best not to attend the BabyBeats class. We do not recommend you attend a BabyBeats class within 24 hours of your baby's immunisations.

I take full responsibility for myself and my baby.

I take full responsibility for myself and my baby relating to any BabyBeats class.

I will seek the advice of my GP or Midwife before commencing BabyBeats classes if have any concerns.

I confirm I will not be using oil or cream until I have done a patch test 24 hours prior to the class.

If any health issues, injuries or concerns for myself or my baby arise over the period the classes run, I will inform my teacher and seek medical advice where appropriate.

I have read and agree with the above statement

Photo Release Statement

I give BabyBeats permission to use my photograph or photographic image in official BabyBeats business, including website, newsletters, videos, media etc. I understand that photographic images or video may be used for news organizations and promotional purposes. I hereby waive any right that I may have to inspect or approve the finished product in which a photographic or video image may be used including the advertising copy or other matter that may be used in connection therewith or the use to which it may be applied.

Yes, I agree with the photo release statementNo, I do not agree with the photo release statement