Name *

First Name

Last Name

What is your date of birth? *

MM

DD

YYYY

Please list the full name of the person I should contact in case of emergency *

First Name

Last Name

Are you pregnant?

Yes

No

Have you ever had any of the following?

Please tick any that apply to you

Heart Disease or Heart Attack

High Blood Pressure

Stroke

Asthma/Bronchitis

Muscular Pain (more than just from workout soreness)

Hernia

Heart Palpitations

Low Blood Pressure

Please indicate you understand I have a 24 cancellation notice requirement for private appointments. Failure to cancel within this time period prior to your session commencement will result in you being charged the full fee for the appointment. *

Yes

No

If you are managing injury/illness please confirm that you have been given clearance to train from a relevant medical expert

You only need to answer this if it applies to you

Yes

No

Please indicate you agree to keep me informed prior to lessons of any changes to your health status *

I agree

The PP virtual studio operates with a positive, inclusive culture. Please indicate you understand my right to refuse service to clients I feel undermine or endanger this *

I understand and accept

Distractions to workouts can be dangerous or at the very least disrupt our virtual lessons. Please ensure that you workout in a quiet space, or if you can't be free from disruptions place your feed on mute so as not to disturb other clients working out in the group *

I understand and accept

You understand and accept my ownership of my schedule and my right to cancel and change session times as I require *

I understand and accept

I have a great ethic for work and turning up for clients, but very infrequently sessions may need to be cancelled due to illness or emergency. Just as workers are entitled to sick leave each year, you'll understand that these periods unfortunately occur. *

I understand and accept

Please let me know if you agree for your image to be captured and used in marketing and social media posts *

I agree to allow Proper Pilates to capture my image for publication

I do not agree to allow Proper Pilates to capture my image for publication

Please confirm you've read through and understand our Culture, Privacy and Terms available at this page: https://properpilates.com.au/privacy-tc

I confirm

Upon submitting this form you acknowledge by re-entering your name below that the above details are true and current *

First Name

Last Name