Enrolment Form

Every new client will need to complete a client registration form before joining a class to enable me to create classes most suited to your individual needs and goals so you can get the most from every session.

We can update these as necessary as we work together. This information is completely confidential. I can’t wait to meet you!

Personal Information

First name

Last name

Address

Phone

Occupation

Date of Birth

Day

Month

Year

How did you hear about me?

Emergency Contact

Name

Phone

Health & Fitness

Do you have any injuries I should know about?

Are you have any health conditions I should know about?

Are you currently on any medication?

Do you have any aches/pains?

Have you had any significant operations I should know about?

Are you currently pregnant?

What previous Pilates experience do you have?

What does your average physical activity look like per week?

Any other information you feel might be helpful?

What are your goals from our Pilates sessions together e.g. improve posture, improve muscle tone, improve flexibility etc.?

Please tick to confirm that you agree with the below statement and that you have read and understand our privacy policy.

I confirm that I have read, understood and honestly answered the questions above and I wish to participate in Pilates sessions with Pilates on the Wolds. I understand the various risks associated with an exercise programme and I have not withheld any relevant information regarding my physical condition, which may affect me during or following these sessions. I will work at an appropriate level for myself and stop if I feel pain or discomfort, and inform Ginni. I agree that Ginni Douglas is not responsible for any injuries sustained by me during my exercise session. I hereby release Ginni Douglas and all parties involved from any responsibility. The nature of Pilates involves hands on guidance as means of facilitating precision during exercise. By signing below you are indicating that you are happy for me to use hands on guidance where appropriate. I agree to adhere to the 24 hour cancellation policy and will pay for my late cancellations.

Signature

Signature field is empty.

Date

Day

Month

Year