🌸 LITTLE LOTUS LOUNGE 🌸

Children’s Party Waiver & Parental Consent Form

Pamper • Play • Sparkle All Day ✨

Thank you for choosing Little Lotus Lounge! To help us keep every child safe, please complete one form for each child attending the party.

 

CHILD’S DETAILS

Child’s Full Name:_________________________________________________________________________________

Date of party :_____________________________________________

EMERGENCY CONTACT

Emergency Contact Name:____________________________________

Relationship to Child:_______________________________________

Emergency Contact Number:__________________________________

 

MEDICAL & ALLERGY INFORMATION

Please tick ✓ where applicable:

☐ No known allergies

☐ Food allergy — please provide details below

☐ Skin/product allergy or sensitivity

☐ Asthma

☐ Epilepsy/seizures

☐ Diabetes

☐ Other medical condition

Please provide details of any allergies, medical conditions, medications, special requirements or anything else we should be aware of:

 

Does your child carry an inhaler, EpiPen or other emergency medication?

☐ No
☐ Yes — details: _________________________________________________

If medication is required during the party, please speak to a member of the Little Lotus Lounge team before the party begins.

 

ACTIVITIES & CONSENT

Little Lotus Lounge parties may include activities such as:

✨ Hair braiding
✨ Face glitter / face gems
✨ Nail painting
✨ Pamper activities
✨ Foot soaks
✨ Face masks
✨ Crafts
✨ Dancing & karaoke
✨ face painting 

I understand that some activities involve the use of cosmetic, craft or other products that may occasionally cause skin irritation or an allergic reaction.

I confirm that I have provided accurate information about my child’s allergies, medical conditions and sensitivities.

☐ I give permission for my child to take part in the activities included in their chosen party package.

If there are any activities you do not want your child to participate in, please list them below:

I understand that, while every effort is made to provide a safe and supervised environment, participation in events and activities carries some level of risk. By agreeing to this document, I accept responsibility for my child's involvement and release little lotus lounge, including its owner, and representatives, from any claims relating to injury, loss, or damage arising from participation in the event.

PHOTOGRAPHY & SOCIAL MEDIA

Little Lotus Lounge may take photographs or videos during parties for promotional purposes, including social media and advertising.

Please choose ONE:

☐ YES — I give permission for photographs/videos of my child to be used by Little Lotus Lounge for promotional purposes.

☐ NO — I do not give permission for photographs/videos of my child to be used for promotional purposes.

 

EMERGENCY MEDICAL CONSENT

In the unlikely event of an emergency, I understand that Little Lotus Lounge will take reasonable steps to ensure my child receives appropriate assistance and, where necessary, emergency medical attention may be sought.

I understand that the parent/guardian will be contacted as soon as reasonably possible.

☐ I consent to emergency medical assistance being sought for my child if required.

 

COLLECTION & AUTHORISED ADULTS

My child will be collected by:

Name:______________________________________________________

Relationship to child:_______________________________________

Contact number:_____________________________________________

If someone other than the person named above is collecting my child, I understand that I must notify Little Lotus Lounge in advance.

 

PARENT/GUARDIAN DECLARATION

I confirm that:

• The information I have provided is accurate and complete.
• I have informed Little Lotus Lounge of any allergies, medical conditions, medication or additional needs that may affect my child’s participation.
• I understand that children should follow the instructions given by Little Lotus Lounge staff during activities.
• I understand that reasonable care will be taken to provide a safe and enjoyable environment.
• I will inform Little Lotus Lounge if any of the information provided on this form changes.
• I understand that Little Lotus Lounge cannot be held responsible for information that has not been disclosed to them.

Parent/Guardian Full Name:___________________________________

Signature:__________________________________________________

Date:______________________________________________________

 

🌸 THANK YOU! 🌸

Thank you for helping us make Little Lotus Lounge a safe, happy and magical place for every little guest. 💕✨

Little Lotus Lounge
Pamper • Play • Sparkle All Day