Minor Consent Form

Contact Info (for child's parent or guardian):

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Being the parent (or legal guardian) of the above child I understand the following:

I understand that the session provided by Eloise Ansell is intended to enhance relaxation, increase communication within areas of the body, and to educate me to possible energetic or emotional blocks that may create pain and disease.

I acknowledge that modalities used are non-invasive, safe, and objective and that it utilises the body’s own innate intelligence to re-establish communication within itself.

I understand that participation in a session with Eloise for my child is voluntary and that at any time I may choose to end their participation.

I understand that so-called detoxification symptoms or release during the 24-48 hours following the session may be experienced, particularly if they have been experiencing chronic or heightened levels of stress.

I understand that sessions are not a substitute for medical treatment or medications.

I am aware that Eloise Ansell does not diagnose, nor does she prescribe medication.

I am aware that any medical issues or concerns should be addressed with a qualified doctor.

I understand that information exchanged during any session is educational in nature and is intended to help me become more familiar and conscious of my child's health status and is to be used at my own discretion.

I agree to pay the agreed fee per session for anything up to 30 minutes in duration (sessions can last 10 mins) and I understand that a 24-hour cancellation notice is required to avoid a fee.

I understand that there are no refunds after a session.

I understand Eloise will record & keep audios of the sessions for her records.

I understand my email will be added to Eloise’s mailing list and agree to receive emails. This includes ones of a marketing nature as well as up-to-date information regarding Eloise’s services. Eloise will not share my information with third parties & keep my data safe. I understand I can cancel this service at any time.

Eloise's full Data Protection Policy is available here.

I understand that for a free cancellation for distance (remote) sessions, I will inform you (preferably by text/WhatsApp, or email if not) at least 24 hours prior to the appointment.  I will be charged 50% of usual price for cancelling on the day of my appointment.

I understand that the information on this form and any information imparted during these sessions are strictly confidential in nature and will not be shared with anyone without my written permission. General information, excluding names, may be used to help others further understand the efficacy and use of any modalities Eloise teaches.