Enrolment Form Please fill out the form below to register you and your baby onto the baby massage course. Name * First Name Last Name Email * Phone (###) ### #### Baby’s Name First Name Last Name Baby’s Birth Date * MM DD YYYY Does baby have any ongoing health issues that I should be made aware of? * If the answer is yes, please speak to a health professional before you come along to your first session Yes No Was baby full term? yes no Does your baby have any allergies you are aware of? * Yes No Do you have any allergies? * Yes No Do you have any health issues that may affect your class participation? * yes no Are there any aspects of baby massage that you are worried about? yes No Is there anything else you feel I should know? Yes No I will be in touch shortly by email to confirm your booking and request payment. Thank you so much for your booking!
