Enrollment Form

Participation Informed Consent

If you are unsure as to whether you should practice Pilates due to any health problems, please consult your doctor.

While every effort is made during the classes to provide practices which are suitable to the student, it is the duty of the student to inform the teacher of
all illnesses or weaknesses of whatever nature which might render the practices, exercises and training injurious or strenuous to the student.

It is not necessary for the student to undertake the practices, exercises and training suggested by the teacher. All practices are undertaken by the
student voluntarily and in the event of the accident or injury no claim will lie against the teacher or the owner of the premises or the organiser of the
classes.

    Health Questionnaire

    Are you currently experiencing any of the following conditions? Please tick if applicable.


    YesNo


    YesNo


    YesNo


    YesNo


    YesNo


    YesNo


    YesNo


    YesNo


    YesNo


    YesNo



    AsthmaBronchitisArthritisDepressionDiabetesMEStrokeOsteoporosisCancerOther


    Your Details








    Your Signature


    Yes