Private 1:1 Movement Intake Form

1. Medical Clearance

You must speak to your GP or healthcare professional before beginning if you have any medical conditions, injuries or concerns about exercising. By booking, you confirm you are medically safe to participate or accept responsibility for doing so.

2. Pregnancy

I do not work with clients who are pregnant or in the early postnatal period.
If pregnancy occurs during your block, please inform me so we can pause safely.

3. Packages & Session Length

• Sessions are 60 minutes

• Packages available as 4-week or 8-week blocks

4. Payment Requirements

• A 25% non-refundable deposit is required before you submit the intake form and before any programme creation begins.

• The remaining balance is due before your first session (unless using a payment plan).

• Packages are non-transferable.

5. Programme Ownership

All programme content remains the intellectual property of Yoga with Keeley.
If you choose not to continue after your programme has been created, I reserve the right to retain all materials.

6. Cancellations & Rescheduling

• Minimum 24 hours’ notice required

• Less than 24 hours = full session fee

• Alternative weekly slots may be offered but are not guaranteed

7. Refunds

• 25% deposit is non-refundable

• If you cancel within 48 hours of your start date, the deposit is retained

• After session 1, the full block becomes non-refundable

• In cases of injury, illness or major life changes, we can discuss pausing or adapting sessions

8. Client Responsibility

You agree to:

• work within your limits

• stop if anything feels unsafe

• update me on health changes or medication

• acknowledge the risks of physical movement

9. What These Sessions Are

Strength-focused, yoga-informed movement sessions supporting:

• joint stability

• functional strength

• mobility

• nervous system regulation

• confidence in your body

10. What These Sessions Are Not

Sessions are not:

• medical treatment

• physiotherapy

• counselling or therapy
  and do not replace professional medical advice.

11. Venue & Travel

Sessions may take place at your home or another agreed venue.
Travel fees may apply outside my usual area.

12. Confidentiality

All information you provide is kept confidential and used only to support your sessions.

Health & Safety

Your safety and wellbeing are central to how I teach.

My responsibilities:

• Provide safe, supportive, tailored guidance

• Offer modifications and alternatives where needed

• Use nervous-system-aware pacing

• Maintain professional standards and appropriate insurance

• Encourage open, honest communication

Your responsibilities:

• Share relevant health information honestly

• Move within your limits

• Let me know immediately if something feels painful or unsafe

• Inform me of any changes in your health or medication

• Seek medical clearance when necessary

Payment, Deposit, Cancellations & Refunds

Deposit

• A 25% non-refundable deposit is required before submitting the intake form and before any programme creation begins.

• This deposit secures your booking and covers the time reserved for you.

Balance

• Remaining payment is due before your first session unless we agree on a payment plan.

Cancellations

• Sessions cancelled with less than 24 hours’ notice are charged in full.

• I will try to offer an alternative slot within the same week, but this cannot be guaranteed.

Refunds & Pausing

• If you decide not to continue within 48 hours of your agreed start date, the deposit will be retained.

• After your first session takes place, the full package fee is non-refundable.

• If illness, injury or major circumstances arise, we can discuss pausing your block.

Privacy & Data Protection

To support you safely, I collect limited personal and health information.

What I collect:

• Contact details

• Relevant health information

• Movement + lifestyle history

• Session notes (where applicable)

How this is used:

• To plan safe sessions

• To tailor movement to your body and goals

• To contact you about your sessions

How this is stored:

• Securely and confidentially

• Never shared unless legally required

• Never used for marketing without consent

You can request to view or delete your information at any time.

Liability & Risk

By taking part, you acknowledge that:

• movement and exercise carry inherent risks

• you participate voluntarily

• you must inform me of any health changes

• you are responsible for moving within your limits

• medical clearance is recommended where appropriate

To the fullest extent permitted by UK law, Yoga with Keeley is not liable for injury, loss or damage arising from participation except where such liability cannot be excluded.

Programme Ownership (Intellectual Property)

All programmes, plans, content, written materials and guidance created for you remain the intellectual property of Yoga with Keeley.
If you choose not to continue after a programme has been created, all materials will be retained.
These materials may not be copied, shared or used without permission.