Parent/Guardian Name (required)
Your Email (required)
Your Phone (required)
Your Child's Name (required)
Child's Age (required)
Child's Shirt Size (required)SmallMediumLarge
Medical information staff should be aware of, including allergies:
Are there any foods or drinks that your child cannot consume?
List names of who is able to pick up:
Emergency Contact 1: (required)
Emergency Contact 1 Phone: (required)
Emergency Contact 2:
Emergency Contact 2 Phone:
Yes, I Agree I, parent/guardian of the above named participant in the following activity, Prissy Missy Spa, hereby give approval for her participation in any and all activities during the duration of the program. I assume all risks and hazards incidental to participation including transportation to and from activities; and hereby waive, release, absolve, indemnify and agree to hold harmless Prissy Missy Spa, local league organization, Prissy Missy Spa, sponsors, supervisors, officials, participants and all other persons involved in various capacities with the above activity for any claims, demands, or courses of action arising out of or by reason of the above activity for which the participant is registered. I also give my permission for the free and unrestricted use of my name and picture in any broadcast or written account of the event/activity.
Yes, I Agree I also grant permission to managing personnel or other league representatives to authorize and obtain medical care from any licensed physician, hospital or medical clinic should the participant become ill or injured while participating in said activity or any associated activities at times when neither parent/guardian is available to grant authorization for emergency treatment.
Yes, I Agree I, the parent/guardian of the above named participant will arrive with children that have been bathed, will have clean hair and trimmed nails in preparation for the spa services. Any child that is observed lacking hygiene, has head lice or any type of fungus may be denied services at that time of event.
Yes, I Agree I, the undersigned, parent/ guardian assume all risk and hazards incidental to participating in the activity including those that may arise out of the negligence of other participants and hereby waive, release, absolve, indemnify and agree to protect, defend and hold harmless its owners, staff and participants for any claim arising out of any injury to myself/ child to the fullest extent allowed by law. I, the undersigned, parent/ guardian of the participant, am fully aware of the potential dangers and risk inherent in this activity, including physical injury, death or other consequences that may arise or result directly or indirectly from participation in all salon and spa services and activities. This is to certify that the participant(s) listed below is in good physical condition has no recent exposures that would be contagious to others, and has my permission to participate in the total program. In case of emergency, I hereby give my permission for Prissy Missy Spa on to any emergency room and hospitalization, I also authorize to secure the use of any ambulance, if necessary, for transporting the child to the hospital. I further agree to pay the hospital, doctors, and ambulance fee for all services rendered to the child(s) name above.
Yes, I Agree I, the parent or legal guardian of the child/ children mentioned above grant Prissy Missy Spa, my permission to use photographs taken during this event for any legal use, including but not limited to: publicity, copyright purposes, illustrations, advertising and web content. Furthermore, I understand that no royalty, fee or other compensation shall become payable to me by reason of such use.
Parent/Guardian Signature (required)
Todays Date (required)
For more information on our services or additional questions, please email email@example.com