Client Enrolment Form

Please take a few minutes to fill in the following information

Birthday

Month

Day

Year

Do you have medical clearance to exercise?

Yes - I'm OK to exercise

No - I need to obtain medical clearance

How did you hear about Core Pilates classes?

Emergency Contact Details

Name & Telephone Number of Emergency Contact

Background & Health

What are your sports/hobbies?

What is your Pilates experience (please select all that apply)

If you ticked any of the above please provide further details below

If you had any minor surgery in the past two years or major surgery in the past ten years please provide details below

What health or physical goals would you like to achieve in the next three months (short term) and 12 months (longer term)?

I have answered the questions above to the best of my knowledge, disclosing all relevant information. I know of no other reason why I should not undertake a course of exercise. I will inform my teacher if my medical condition changes in the future.

I understand that the teacher can accept no liability for personal injury related to participation in a session if:

• My doctor has advised me against such exercise

• I fail to observe instructions on safety or technique

• Such injury is caused by the negligence of another participant in the class/studio.

I understand that exercise should be performed at a pace which feels comfortable to me and that pain, as the body’s warning system, should not be ignored. I will inform the teacher immediately if I feel any discomfort during or after a session. I understand that all exercise carries a risk of injury and I accept responsibility for my own body.

Occasionally, photos or short video clips may be taken during sessions for marketing or social media. I will always be informed beforehand and can opt out at any time.

I confirm that I have read and understood the above and that the information I have given is correct

Terms & conditions

Core Pilates and Your Coach Caroline are trading names of Tiny Goat Ltd (company number: 16659247), registered in England and Wales. All contracts for services are entered into with Tiny Goat Ltd. Please review the full Terms & Conditions

I agree to the terms & conditions

I would like to subscribe to receive occasional emails with updates, tips, and offers from Core Pilates

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