Parental/Legal Guardian Consent

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Parental/Legal Guardian Consent Of Minor Under 18

Email *

Beachside Boutique requires all persons under the age of 18 to have parental consent. In addition to the above, all persons under the age of 16 are required to have a parent/legal guardian present during the treatment. Please select & acknowledge all requirements below. *

Any minor under the age of 16, requires a parent or legal guardian to be present & remain in the treatment room for the entirety of the minor’s treatment

Any minor under the age of 16, requires a parent or legal guardian, if needed, to assist the minor in preparing for their treatment

You agree that you are the parent or legal guardian of the said minor and that you give consent to Beachside Boutique to preform the requested service

You as the parent or legal guardian have completed the treatment specific form as well, informing the therapist of all relevant medical history, contraindications and concerns

Other:

Required

Minors First & Last Name *

Minors Birthday *

YYYY

Parent/Legal Guardian’s First & Last Name *

Parent/Legal Guardian’s Phone Number
*

Today’s Date *

YYYY

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