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Please take a moment to read and complete the below form.

Submission is required at least 3 days before your first class. All information will be treated as strictly confidential.

Please note, for staff safety please ensure there is no pets eg. dogs, cats, birds in the area of entry and your class. We need to be advised of all people on the property prior to class commencement (where possible). A safe clean floor space is required for your class. Should this not be followed your class may be cancelled with no refund provided.

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* 1. Parent / Guardian Name & Contact Details

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* 2. Residential address where your class will be held

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* 3. Child Name

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* 4. Child Date of Birth (DD/MM/YY)

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* 5. Child 2 Name

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* 6. Child 2 Date of Birth (DD/MM/YY)

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* 7. Please detail any relevant medical conditions or allergies. 

You may be contacted to discuss.

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* 8. Additional Information

Please add additional information here including anyone who will be present at your house at the time of your class.

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* 9. At times, Nurture Wellbeing may take photographs or videos during classes and other activities for publication on the website, social media and marketing purposes.

If you do not wish to be photographed, please make this known at the time of booking. By agreeing to these terms and conditions you are granting Nurture Wellbeing the right to use photographs or videos and any adaptations of them, for all general purposes in relation to Nurture Wellbeing work including, without limitation, publicity materials, books, newspapers, magazine articles, social media, whenever Nurture Wellbeing choose to do so.

I will never take photographs or video of your baby during massage when they are fully naked, only when they are wearing a nappy and / or clothes and only if you have given your consent. Parents are permitted to take photographs of their child but only their child during classes.

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* 10. Wavier
I hereby agree to the following: I recognize infant massage, as with any massage service or physical activity, carries a risk of accident or injury. I am fully aware of the risks and hazards involved and hereby assume the risk connected with participation in a class with Christie Barker or Nurture Wellbeing.

I understand that it is my responsibility to consult with a physician prior to and regarding my participation in any massage program. I affirm that my baby / child and I are in good health and suffer from no physical impairment that would limit his / her participation in an infant massage class. I understand that it is my responsibility to detail any injuries, allergies, additional needs and health conditions on this form.

If taking part in a baby class, I confirm that my infant has had their 6 or 8 week check and / or been confirmed free from any joint / skeletal disorders / abnormalities / conditions. Please advise if your baby is younger than this.

I understand that my baby should refrain from massage for 3 days after immunisations, in the area of injection in case of any side effects or soreness. I acknowledge that Christie Barker and Nurture Wellbeing will not render any medical services including medical diagnosis of my child’s physical condition.

In consideration of being permitted to participate in a massage classes, I agree to assume full responsibility for any risks, injuries or damages, known and unknown, which I or my child might incur as a result of participating in the program. In further consideration of being permitted to participate in the massage classes, I knowingly, voluntarily, and expressly waive any claim I may have against the instructor, the owner, or the leaseholder of the building for injuries or damages that I or my child may sustain as a result of participating in classes or workshops held by Christie Barker and Nurture Wellbeing.

I have read the above release and waiver of liability and fully understand its contents. I voluntarily agree to the terms and conditions stated above

Covid-19
Please refer to our Covid-19 Policy to be informed what we are doing to keep our community healthy.

If you are unwell, please stay home and contact us to arrange a make-up class.

If your instructor test positive with Covid-19, unless a substitute teacher can be arranged, classes will be cancelled for the duration of illness. An alternative class date will be arranged once recovered.

Please advise us if you test positive within 14 days of attending a class.

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