Minor Consent Form

Minors are permitted to receive massage by Massage by Daniel.

Fields marked with * are required.

- Minors (all clients under the age of 18 – unless otherwise emancipated) can only receive massage with written parental/legal guardian consent

- In collaboration with the consenting adult and child, the massage therapist will assist in establishing goals for the session(s).

- For clients age 13 and under, the parent/guardian must always be present in the treatment room.

- For clients age 14-17 if both client and parent/guardian are comfortable with the child being in the session room by themselves, check the box

Otherwise, parent/guardian should be in the treatment room during each session. Once a comfortable therapeutic relationship has been established and the massage therapist, child and parent are comfortable the parent/legal guardian does not have to be present in the room.

- Appropriate draping will be always used during the massage, only areas being massaged are uncovered.

I (enter your name below)*

am the parent/legal guardian of (enter your child's name below)*

I have read the above information and give permission for my child to receive massage therapy from _Daniel Marquez_ LMT_.

By typing your full name below, you are electronically signing this document and agree that this signature holds the same legal weight as a handwritten signature*