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Baby Reflexology Class Enquiry Form
Parent Contact & Availability Information
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NAME OF PARENT/CARER
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YOUR RELATIONSHIP TO THE CHILD
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EMAIL ADDRESS
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CHILD'S NAME
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CHILD'S DATE OF BIRTH
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IS THERE ANYTHING IN PARTICULAR YOU ARE HOPING BABY REFLEXOLOGY MAY HELP WITH? DOES YOU CHILD HAVE ANY MEDICAL CONDITIONS OR ALLERGIES?
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CURRENTLY I AM RUNNING A COURSE ON FRIDAYS AT 3PM. PLEASE LET ME KNOW IF A FRIDAY AT 3PM WOULD WORK FOR YOU OR IF A DIFFERENT DAY/TIME WOULD BE BETTER. I'LL TRY TO ACCOMODATE IF I CAN:
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