Move With Marie - Client Intake Form

✨ Basic Details

Name

Date of Birth

Pronouns

Phone Number

Emergency Contact Name

Emergency Contact Phone

🫶 Tell Me About You

What’s your current fitness vibe?

(Anything counts — walking, Pilates, lifting, dancing in the kitchen, nothing at all… no judgment.)

Any injuries, health conditions, sensitivities?

I want to keep you safe, strong, and supported.

How would you describe your relationship with movement right now?

We’re friends but we don’t hang out often.

It’s complicated.

On-again off-again situationship.

Obsessed but in a healthy way.

🎯 Goals + Intentions

What goals are you hoping to achieve during our time together?

(Strength, confidence, consistency, mobility, aesthetics, energy, stress relief, all the above… anything goes.)

How do you want to feel after each session?

(Empowered? Sweaty? Calm?)

🎶 Your Training Vibe Check

How do you want your sessions to feel? Pick one or mix ’n match:

a) The Solo-Class Star

Little convo, loud music, constant flow, all the cueing + adjustments

b) Light + Conversational

Check in with me, chat with me, feel out the workout based on the day, move intuitively. Think: “friend who trains me.”

c) The Combo Deal

A lil’ push, a lil’ fun. Give me challenges, give me music, give me gab, give me gains.

d) Build-My-Own-Vibe

Tell me exactly what you want:

📝 Anything Else?

Is there anything you want me to know about you, your habits, your schedule, or your goals?

Or just tell me a fun fact — I love a fun fact.

📅 Cancellation Policy

Please review our cancellation policy carefully:

I understand that cancelling a session within 24 hours of the scheduled time will result in forfeiting the full cost of the session, unless the cancellation is due to an emergency.

I have read and agree to the Cancellation Policy

✍️ Waiver & Release

Assumption of Risk and Release of Liability

I hereby acknowledge that I am voluntarily participating in physical exercise and training sessions with Move With Marie. I understand that there are inherent risks involved in physical activity, including but not limited to the risk of injury, heart attack, or death.

I assume all risk of injury or harm to myself associated with my participation in this fitness program. I certify that I am in good physical condition and have no medical reason or impairment that might prevent me from participating in this program.

I hereby release Move With Marie, its owners, employees, and agents from any and all liability, claims, demands, actions, or rights of action, which are related to, arise out of, or are in any way connected with my participation in this fitness program.

I have read and understood this agreement and I am aware that by signing this I am waiving certain legal rights which I or my heirs, next of kin, executors, administrators, and assigns may have against the Releasee.

I have read and agree to the Waiver & Release of Liability

Inquire & Get Started