Client Enrolment Form

ALL INFORMATION WILL BE TREATED IN THE STRICTEST OF CONFIDENCE

Personal Details
Please enter todays date*
Name*
First Last
Contact Telephone Number (Mobile preferred)*
Where possible this should be your Mobile number or the best telephone number to contact you on in an emergency.
Email*
Your privacy is very important to us. We will never disclose email addresses to third party companies.
Enter Email Confirm Email
Sex
- Female
- Male
Date of Birth
Occupation
PLEASE ADD EMERGENCY CONTACT DETAILS HERE
Winchester Pilates Ltd will assume that express permission has been sought from the person named and that they have consented to us holding and processing their contact information in the case of an emergency.
Name, telephone number and email address of an emergency contact
First Name Last Name Telephone Email address

PART 2 – YOUR AIMS
23. WHAT ARE YOUR REASONS FOR TAKING UP PILATES?
24. WHAT HEALTH OR PHYSICAL GOALS WOULD YOU LIKE TO ACHIEVE OVER THE NEXT THREE MONTHS?
25. WHAT LONGER-TERM HEALTH OR PHYSICAL GOALS WOULD YOU LIKE TO ACHIEVE OVER THE NEXT 12 MONTHS?
PART 3 – IMPORTANT INFORMATION
Please advise us before commencing any session if, for any reason, your health or your ability to exercise changes.
It is inadvisable to do Pilates between weeks 8 to 14 of pregnancy, unless by special arrangement with your teacher. It is also wise to wait six weeks after the birth before resuming exercise.
Pilates exercises are very safe but, as with all forms of physical exercise, it is prudent to consult your doctor before starting Pilates sessions.
These sessions are not a substitute for medical counselling or treatment. If you have any doubts about the suitability of the exercises, you should refer back to your medical practitioner. The teacher can accept no liability for personal injury related to participation in a session if:
• Your doctor has, on health grounds, advised you against such exercise
• You fail to observe instructions on safety or technique
• Such injury is caused by the negligence of another participant in the class/studio
Exercise should be performed at a pace which feels comfortable for you. Pain is the body’s warning system and should not be ignored. Please inform your teacher immediately if you feel any discomfort during a session. Please also inform your teacher if you felt any discomfort after a previous session.
- I understand that Winchester Pilates exercises involve hands-on correction and I hereby consent for my teachers to work in this way.
- I confirm that I have read and understood the above advice and that the information I have given is correct.
Signature*
When you meet your Pilates teacher for the first time they will ask you to sign a printed version of this form.
- I understand that to validify this form I will be asked to sign it by Winchester Pilates

CLIENT ENROLMENT FORM

Step 1 of 3

Personal Details

PLEASE ADD EMERGENCY CONTACT DETAILS HERE

PART 1 – YOUR BACKGROUND AND YOUR HEALTH

PART 2 – YOUR AIMS

PART 3 – IMPORTANT INFORMATION