Breathe With Me registration
Ages 8-12 | Free online session
Second Wednesday of each month at 5:15-5:40 pm UK time. First session: 11 November 2026. This form covers attendance from November 2026 to February 2027; you may withdraw from future sessions by contacting me.
These are gentle, optional breathing and grounding sessions for wellbeing. They are not medical or mental health treatment, and do not involve intensive breathwork. Participants may watch, breathe normally, pause or stop.
Your details
Child or young person's first name
*
First Name
Last Name
Age on first session date
Parent or guardian full name
*
First Name
Last Name
Relationship to child
Parent or guardian email for joining details
*
example@example.com
Parent or guardian phone during session
*
-
Area Code
Phone Number
Participation and consent
If there is an accessibility need or relevant safety concern, please tell me privately using the space below or contact me directly. Share only what is needed to help me assess and adapt the session.
Optional accessibility or safety note
Consent and Agreement Declarations
I confirm I have parental responsibility or authority to register this child and consent to their participation in this group.
I will follow this group's supervision arrangement: A responsible adult remains at home and immediately available.
I will ask the young person whether they wish to take part. They may watch, pause or stop even though I have signed this form.
I understand no one may record, photograph or screenshot another participant, and that sessions are not recorded by Helen.
I have read the privacy notice on page 2 and understand that my information will be used to arrange this session.
Only if I supplied health information: I explicitly consent to Helen using that information to assess suitability and adapt the session as described on page 2.
Parent or guardian signature
*
Date signed
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
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Privacy notice for this form
Helen O'Neill | Last updated 28 September 2026
Who collects your information
Helen O'Neill is a sole trader and is responsible for this information. Contact: info@heleneoneill.co.uk, 07899 898374, 25 Webster Road, Rainham, Kent, ME8 7SD.
What I collect and why
I collect the registrant's name and contact details, the chosen group, consent, a reachable telephone number and any information you choose to provide about accessibility or safety. For a child I collect their first name and age group and the parent or guardian's details. I use this to arrange and deliver the free session, communicate about it, confirm suitable supervision and keep appropriate consent and safeguarding records. I use booking and contact details to arrange the session (contract or steps towards it), and limited records for safeguarding, administration and legal claims where necessary (legitimate interests or applicable legal obligation). I do not use health information for marketing.
Optional health information
Health information is sensitive. If you provide relevant health information so I can consider suitability or adapt a session, I ask separately for your explicit consent to use it for that purpose. You may withdraw that consent by contacting me. If I cannot assess a safety concern without it, I may be unable to offer a particular activity. You do not need to provide a detailed medical history in this form.
Who may receive it
I use service providers for forms, email and video meetings; their access is limited to what they need to provide the service. If you use a Jotform version of this form, Jotform processes the submitted data for me. I may share relevant information with advisers, insurers, safeguarding or emergency services when necessary and lawful. I do not sell your information. Some providers may process information outside the UK; where restricted transfers occur, I use applicable adequacy arrangements or other appropriate safeguards.
How long I keep it
I keep adult registration and consent records for up to six years after the last session, and children's records until their 25th birthday, unless a complaint, safeguarding concern, insurer requirement or legal claim calls for longer retention. Unsuccessful enquiries are normally kept for up to 12 months after last contact. I review and securely delete records when no longer needed.
Your rights
Depending on the circumstances, you can ask to see, correct, erase or restrict your information, object to its use, or ask for a portable copy. You can withdraw consent where I rely on it. Email info@heleneoneill.co.uk. You can complain to the Information Commissioner's Office at ico.org.uk or 0303 123 1113. I do not make solely automated decisions with legal or similarly significant effects.
Joining and safeguarding
The meeting link is sent to the adult registrant or parent or guardian. Do not share it publicly. For children, a parent or responsible adult must remain available as specified on page 1. If there is an immediate risk to someone's safety, I may share necessary information with safeguarding or emergency services. Contact me if you want the fuller website Privacy Notice or children's session and safeguarding information.
For young people: I need your first name and a way to contact your grown-up so you can join safely. You can ask what I know about you, and you can say no to an activity or ask to stop.
Helen O'Neill | Breathe With Me | heleneoneill.co.uk
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