Pilates Class Registration Form

Pilates Registration Form

Client Details

Name:

Date of Birth:

Address:

Postcode:

_____________

Telephone:

Email:

______

GP name and Address:

Please state how you heard of us:________________________________________________________

Pilates Aims

Why have you decided to commence Pilates?

What aspects of your health would you like to concentrate on?

Core Stability

Flexibility

Posture

Strength

Stress Management

Relaxation

What are the three main aims that you are hoping to achieve with pilates?

______________________________

Lifestyle

Occupation: _________________________________

Does your occupation involve repetitive movements or prolonged postures? If so please briefly

explain. ____________________________________________________________________________

What other sports and hobbies are you involved in?

___________________ _____

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Parent category: Life