Desiere’e Professional Stage Hypnotist
2400 Alpine Blvd #9
Alpine, Ca. 91901
(619) 588-9816
GRAD NITE HYPNOSIS SHOW PERMISSION SLIP
To whom it may concern:
Soon your teen will be attending a Grad Nite event where there will be a hypnosis show.
If your teen wishes to be hypnotized and is under the age of 18 years old, please sign and date this permission slip and return to the Grad Nite Committee prior to the event.
Your teen will also be videotaped and have his pictures taken with my cameras.
As ALL Hypnosis is SELF Hypnosis. this is a normal natural state that we enter into approximately 4 times per minute every day.
There are NO known dangers in this natural state.
However, I will not hypnotize anyone under the age of 18yrs without parental consent.
If you have any further questions you can call me directly at (619) 588-9816 and I will answer any questions you may have.
Please note that last year a teen acted out in a reverse way during a teen hypnosis show. He ran around the school , acted out and blamed hypnosis for this.
Now there is a law suit pending against the hypnotist who did nothing wrong.
It is not normal for anyone to do this while in hypnosis or after.
Sincerely
Desiere’e Jellinek C.H.T.
I hereby give Desiere’e Jellinek permission to hypnotize my teen at their Grad Nite event.
Signature of Parent or guardian __________________________________________ DATE_________