Enrolment Form

Fill in the form below and submit before your first class.

PILATES LIFE – MAT CLASSES – Instructor Phil James

Subject:(required)

Message:(required)

Name:(required)

Date of Birth:

Address:

Mobile Phone:

Home Phone:

Work Phone:

Email:(required)

Occupation:

Emergency Contact Name:

Emergency Contact Phone:

Where did you hear about the classes ?

Exercise History

Have you been exercising regularly ?

Type of Exercise:

Frequency:

Perceived Intensity:

MEDICAL CONSIDERATIONS

Did a medical practitioner / health care professional recommend you commence Pilates ? If so, please give details.

Are you currently having treatment by a medical practitioner, Physiotherapist, Chiropractor, Osteopath or other therapist for any condition that may limit/ hinder/or prevent you from participating in exercises ? If yes, please give details.

Are you pregnant or have you given birth in the last six months ? (Please note that commencing floor classes in the first trimester of pregnancy can be dangerous. )

Is there anything in your medical history or in your current condition which I should be aware of and which would prevent/hinder/limit your participation in Pilate's floor class exercises? For example any back, neck, shoulder or other joint condition or any relevant operations or health / medical issue ?

Terms and Conditions

This form must be submitted or presented no later then the first day of training.
In regard to any medical condition disclosed on this form, participants undertake to obtain a clearance from their relevant treating medical practitioner prior to enrolling in a Pilates floor class.
If, due to unforeseen circumstances a class is cancelled, participants will be offered a monetary credit or an additional class may be scheduled.
Please bring a mat, two bathroom size towels.
Fees are a payment for a certain number of classes at a specific time and venue. All new students pay for eight weeks in advance.
There are no refunds
If you miss a class (any number) if they are available you can do a make up class somewhere else. Make up classes do not continue to build up you must do them within 9 weeks of paying fees.
When classes drop below 3 people I might ask people to join with another class.
If for some reason you are unable to train for more then three classes please call me to discuss fees.

Acknowledgement

Exercise is not without risk to the musculoskeletal and cardio pulmonary systems and I acknowledge I have voluntarily elected to participate in a Pilates floor / mat exercise program with the instructor Phil James.

I will not hold Phil James responsible for any personal injury loss or damage which may result from my participation in any proposed exercise program. Further I agree to accept the above Terms and Conditions.

PILATES LIFE – MAT CLASSES – Instructor Phil James

Exercise History

MEDICAL CONSIDERATIONS

Terms and Conditions

Acknowledgement

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