Relax Kids With Jennifer

Relax Kids With Jennifer

Please donate using the cash for kids link; https://www.cashforkidsgive.co.uk/campaign/northsound-general-fundraising/fundraisers/relax-kids-with-jennifer/
Virtual Relax Kids / Lego Mindfulness Club

Registration & GDPR Form
Name of child

First NameLast Name
Age of child
Name of 2nd child

First NameLast Name
Age of child
Name of 3rd child
Age of 3rd child
Parent/Guardian Name

First NameLast Name
Address

Street Address

Street Address Line 2

City

Postal / Zip Code
Mobile Number
Email*
example@example.com
Class Attending - suggested donation of £2.50 per class (donated to Cash for Kids), can select multiple classes*

Relax Kids - Anger - Tuesday 7th April 11-11:45amLego Mindfulness - For Sleep - Thursday 9th 2:00-2:45pmParent & Child/ren Story Massage For Sleep - Friday 10th April 3-3:45pmRelax Kids- Monday 13th April Worry April 11:30-12:15
Does your child have any known emotional or behavioural problems? If Yes, please discuss with you Relax Kids Coach
Does your child have epilepsy? Please let your Relax Kids Coach know, as breathing exercises can bring on a seizure
Is your child taking any medications? If Yes, please state what medication
Medication
Is your child willing to do Relax Kids?
Relax Kids / Lego Mindfulness classes could include movement, stretches, visualisations, breathing exercises and children massaging each other (clothed and sitting up). Do you consent to your child being involved in these activities? Please speak to your Coach if you have any concerns *
How did you hear about Relax Kids With Jennifer?
Do you consent to your child/children being included in Social Media pictures and videos?
I individually and as a parent and or guardian of the child or children above hereby agree to the following:Parent’s responsibilities:Relax Kids takes all reasonable care to ensure that it’s programmes are fun and safe. However, I understand that my child will be engaging in a moderate amount of physical activity that may involve some risk of injury. I acknowledge I have been advised to consult with my or my child’s physician with respect to any past or present injury, illness, health problem or any other condition or medication that may affect my child’s participation in the Relax Kids programme.I confirm that I have fully disclosed to Relax Kids and/or the Coach any, and all, conditions (whether such conditions are physical, behavioural or otherwise) that my child has or may have before participates in the class.As far as permitted under Local Law, I assume the above risks and accept responsibility for any injury sustained by my child. I further discharge and hold harmless Relax Kids (including it’s owners, officers and personnel, including it’s Coaches and it’s suppliers) from any liability: arising from any injury to my child or other persons or property caused by my child’s participation in the Relax Kids programme, if that injury is caused by my or my child’s fault: or by a third party unconnected with Relax Kids provision of services; or by events which Relax Kids, including it’s owners, officers and personnel, including it’s Coaches and it’s suppliers, could not have foreseen or prevented, even if they had taken reasonable care.Refund Classes: Pro-rated refunds will be given if cancellation is done, in writing, before the second attended class of the series. I understand and agree that I will not receive any refund or credit for missed classes, but if cancellation of a class is due to failure on the part of Relax Kids Coach that class I will be entitled to a reasonable refund of the charge for that class. After 2 classes it may be apparent to the Relax Kids Coach that classes are not appropriate for a child at this stage, in this instance we will request the child be removed from the class and the balance refunded. Consent and storage of information. This forms collects your name, address and email please contact me for my Privacy Policy. To view Relax Kids Privacy Policy, please visit www.relaxkids.com/privacy-policy*
I consent to you using my email address for future marketing of Relax Kids With Jennifer ONLY *
Signature*

Clear
Date *
Payment by PayPal or BACS, please use your child’s name as reference:

Jennifer Hall - Sort: 09-01-29 Account: 25747384 Or PayPal (friends and family please) jennifertaylor@relaxkids.com

Please feel to contact me by email or phone if you have any concerns; 07583935001

All schools are welcome to a free Relax Kids taster session, if you’d like your school to have one please ask.
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Relax Kids With Jennifer

Virtual Relax Kids / Lego Mindfulness Club