Register for Pilates and Barre Classes Please enable JavaScript in your browser to complete this form.All clients that complete a registration form will be invoiced according to their selections. Registration is not needed for trial classes. By completing this registration form you agree to pay all fees upon receiving your invoice. *AgreedClient name *FirstLastAge of Client *Date of birth *ID number *Previous exercise experience (if applicable) *Name *FirstLastPerson responsible for accountsCellphone number *Person responsible for accountsEmail *Person responsible for accountsResidential address *Person responsible for accountsClasses client will take part in *Pilates Private SessionPilates Duo SessionPilates Group SessionOrientation SessionBarre fitWhich classes would you like to join? *Pilates – Monday 9amPilates – Wednesday 9amPilates – PrivateBarre – Tuesday 9amBarre – Wednesday 6:20pmTell us more about yourself! Does your work involve any of the following? *Sitting for long periods of timeDrivingBendingLifting heavy weightsStandingAny other repetitive actionIs this your first time practising Pilates *YesNoHave you previously attended; *Home workoutsGym classesPilates at another studioDo you have any heart problems? or Do you feel any pain in your chest when exercising? *YesNoAre you pregnant? *If yes, what is your estimated due date?Have you been pregnant in the last 6 months? *If yes, what type of delivery did you have?Do you suffer from headaches? *YesNoDo you lose your balance a lot or become dizzy? *YesNoDo you suffer from high or low blood pressure? *LowHighNormalHave you had any minor surgery in the past 2 years or any major surgery in the past 10 years? *If yes, details please.Are you on any drugs or medication that could affect your ability to exercise? *YesNoHave you been recommended to take Pilates by a specialist practitioner? *GPPhysiotherapistChiropractorBiokineticistOtherDo you give us permission to contact them? If yes, please provide contact details *Medical conditions of client to be considered? *(Please state any health problems, allergies, medical conditions or injuries, and repeated medication needed)Are there any factors that will prevent you from attending regular classes? *Childcare, transport, work, etcMedical Aid (if applicable) *Medical aid plan and number. Hospital preference in case of an emergency. Why are you taking up Pilates or Barre classes? *What health or physical goals do you want to achieve in the next 3 months? *What long-term goals do you have? *Payment of accounts *EFTSnapscanCashPlease select the preferred method of paymentI authorise all medical treatment and/or hospital procedures as may be performed or prescribed by the attending physician and/or paramedics. I waive my right to informed consent of treatment. This waiver applies only in the event that no next of kin can be reached in the case of an emergency. *YesNoI will advise the studio immediately if my health or wellness changes in any way. I understand that it is not advised to do Pilates between 8-14 weeks of pregnancy and 6 weeks after birth (unless arrangements have been made with your instructor. Pilates is very safe, but as with any physical activity there may be risks involved, it is important to consult your doctor before starting sessions. These sessions are not a substitute for medical treatment. Pain is our bodies way of communicating, please inform your instructor of any uncomfortable pain before your next session. *AgreeThe teachers under the umbrella of Barres are of a standard which qualifies them to teach at the level of the class that you are participating in and, therefore, care is taken to provide you with quality and safe instruction. Nevertheless, accidents and unforeseen circumstances can occur. This agreement entails that you hereby give permission for yourself to participate at Barres. I fully understand and accept that all activities shall be undertaken at my own risk. I hereby indemnify and absolve Megg Geri and all staff against and from any claims whatsoever that may arise in connection with any accident, illness, damage or loss to the property of or death or injury to the person aforementioned. The owner and staff of the studio will nevertheless take all reasonable precautions for the safety and welfare of all students, to minimise any foreseeable risk of harm. As far as I know, he/she is physically capable of participating in physical activities and is in good health. Furthermore, I undertake to pay tuition fees by the due date and accept liability for payment should I terminate classes. This notice must be in writing. I acknowledge that there will be no credit or refund of fees should lessons be missed. I understand that all class fees are to be paid upfront. Fees are compulsory wether class is attended or not. I have read and understood the studio guidelines, regulations, terms & conditions and acknowledge all information to be true and correct. *AgreeNameSubmit
