Voilà La Familia paule-dominique anneheim massage therapist cmt 109 Bartlett #203, San Francisco, CA 94110 415-309-5105 |
[email protected] www.VoilaLaFamilia.com
Infant Massage Class Registration CLASS DATES: ______________________________________________________ LOCATION: _________________________________________________________ CLASS TIME: _______________________________________________________ COST: Group Classes: 1 hour 20 minutes (1-10 babies per class) $70 each baby At Your Home - 1 hour 20 minutes $140 *Both classes include organic jojoba oil. Cash / check / Money Order / Paypal (
[email protected]) I require a 72 hour notice cancellation for a refund. CHILD’S NAME: ____________________________________________________ BIRTHDATE: ________________________________________________________ CAREGIVER’S NAME(S): _____________________________________________ ADDRESS: __________________________________________________________ ____________________________________________________________________ PHONE: __________________ MOBILE __________________________________ EMAIL: _____________________________________________________________ REFERRED BY: ______________________________________________________ WHY ARE YOU INTERESTED IN LEARNING INFANT MASSAGE? ____________________________________________________________________ ____________________________________________________________________ IS THERE ANY INFORMATION ABOUT YOU OR THE CHILD I SHOULD KNOW? ____________________________________________________________________ ______________________________________________________________________
