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rebecca@firstembracebirthandbaby.co.uk

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Home
About
Classes
Workshops
- Embrace Active Birth Antenatal Workshop
Covid Secure
Contact

Home
About
Classes
Workshops
- Embrace Active Birth Antenatal Workshop
Covid Secure
Contact

Embrace Baby Massage and Yoga Class Booking Form

Your Details
Baby Details
Emergency Contact Details
Birth Details
Terms & Conditions
Payment

Your Details

First Name

Last Name

Email

Phone/Mobile

Address

Street

Flat or House number

City / Town

County

Postcode

Booking

Please select the date and time of the classes you wish to attend?

Choose your date for the Embrace Baby Massage and Yoga Class?

Baby's Details

First Name

Last Name

Age

Date of Birth

Emergency Contact Details

First Name

Last Name

Relationship

Phone/Mobile

Health Details

Nature of Birth?

Vaginal Birth

Cesarean Birth

Ventose

Forceps

Birth environment?

Hospital

Home

Other

Have you had your postnatal check?

Yes

No

Did you health professional have any concerns?

Did you have any Stitches & or Tears?

Yes

No

Please share degree of tear if applicable?

Since birth have you experienced any of the following?

Back pain

Sciatica

High blood pressure

Low blood pressure

Anaemia

Prolonged bleeding

Exhaustion

Sacro ilac pain

None of the above

Any other concerns

Do you or your child have any health concerns or medical conditions?

Safety Guidelines

When practicing never rush or force anything. If you feel stressed or tense, just take a break and come back to the practice later.
Always ensure that you feel safe, secure and confident.
Never do anything that you do not feel comfortable with.
Always take the option you are comfortable with.
Only work within your limits

Do you or your child have any allergies?

Terms & Conditions

I take photographs and videos during class. Please confirm if I am able to use for social media & advertising?

Yes

No

Advertising

Disclaimer

Please sign the following disclaimer.

I have read the above safety guidelines and will ensure that I adhere to them.
I fully understand that the recommendations, ideas, or techniques expressed and described during yoga classes cannot be regarded as a substitute for the advice of a qualified medical professional.
I take full responsibility for all application of Yoga practise in the class and outside the class.
If I have any doubts, I will seek the advice of my medical professional before proceeding with Yoga.
I will keep the Yoga Teacher informed of any health issues or changes that arise over the course of the classes.

Signature

Sign Here

Please tick to confirm you have read & agree to the terms & conditions.

Terms & Conditions - Payment is due on booking. Places will be booked on a first come first serve basis. Due to current class number restrictions failure to pay will mean your place will be offered to someone else. Classes are booked in blocks and for this reason, are non refundable. If lockdown occurs again classes will be moved to online until we can resume face to face sessions again. Thank you for your understanding. Please tick to confirm you agree to make your payment.

I agree to the Safety Guidelines and Terms & Conditions.

Course Fee

£60.00

Coupon

Apply Coupon

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Pay with Card (Stripe)

Classes

Embrace Pregnancy Yoga and Hypnobirthing Class Hove
Embrace Baby Massage and Yoga Class Hove

Workshops

Embrace Active Birth Antenatal Workshop
KG Hypnobirthing Workshop

Qualifications

Privacy Policy | Cookie Policy | Terms and Conditions

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