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Booking form Booking Form

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					         Booking Form for Mother & Toddler SMART Class
                      (Stretch, Move & Relax Together)
                          SMART CLASS for toddlers and Parents / Carers:
   Stretch, Move and Relax Together – a continuation of the baby yoga approach for mobile babies and
 toddlers. Using songs and rhymes alongside plenty of movement and stretching, this class is designed to
                    support the transition from babyhood to independent movement.
 An opportunity for parents to exercise and have fun with their children, promoting strength, flexibility,
                        balance and relaxation to contrast with energetic activity.


Name:

Address:




Phone number:                                  Mobile number:

Email:

Child’s date of birth:

Child’s name:                                                   Male/Female

Emergency contact name & telephone number:
(in case ill in class)



        The cost is £27 for a 6 week course.
        The full amount must be paid in advance.
        Please make cheques payable to Samantha Dalton
        I confirm I have read the Terms and Conditions               Yes/No

        I agree to respect the confidentiality of other members in the class.
        I understand that neither Flutterbabies nor Birthlight will not be liable for any loss, damage or
         injury which may occur whilst I am attending classes.
        I agree to inform the teacher of any change in the medical condition of my child or myself at the
         start of any session. (You will be asked to complete a confidential medical form before the first
         class).
        I enclose payment of __________________



    Signed:                                            Date:

    Where did you hear about the class?


           Samantha Dalton      tel: 01937 558500 / 07768 538527         www.flutterbabies.co.uk

				
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posted:8/17/2011
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