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Consent Form
Attendee Full Name
Attendee Mobile No.
What service are you attending?
Choose an option
Secondary Emergency Contact
In case of emergency contact name
In case of emergency contact mobile no.
In case of emergency contact relationship
Health & Safety
Do you suffer from any allergies?
*
No
Yes
Do you have any illness or injury that we need to be aware of?
*
No
Yes
Are you taking any medication tha? we need to be aware of?
*
No
Yes
Do you have any special needs that we need to be aware of?
*
No
Yes
If you answered yes to any question, please elaborate
As a small business we are trying to spread the word that we are here, please check this box if you are happy to be in pictures for our website and social media (We don't use full face shots and this is not mandatory)
You are aware that during this service the person attending will be using a sewing machine, hand needles, irons and scissors and therefore you understand the risks.
Consent Form Initials
I declare that the info I’ve provided is accurate & complete
Thanks for submitting!
SUBMIT
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