Your Information

Next of kin details

General Information

How did you hear about our studio or who referred you to us?
What are your goals?
What do you want most from this Pilates program?
Please describe your current level of physical activity?
Have you had any past training in the Pilates method?
If yes,where?
Are you presently doing other kinds of therapy?
eg massage, physio, chiro etc?
Do you have any injuries, aches or pains, recent or old?
If so please describe.
Are there any other health concerns?
e.g asthma, diabetes, high blood pressure, medications, etc

Level of Commitment

How many times a week would you like to do Pilates?
Would you like a wellness evaluation? (Herbalife programme)

Terms & Conditions

If you are pregnant, please supply us with a note from your doctor stating you are able to start this exercise program.
As a member of POWERPILATES I will utilise the facility entirely at my own risk and expressly indemnify POWER PILATES against any claim I may have against POWERPILATES and or its staff whatsoever cause arising.

Please read the Terms & Conditions here
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