Getting Started

Client Enrollment Form

Please fill out the following form to help us understand your physical condition.

Do you have any health or medical problems? eg; hearth issues, asthma, high blood pressure
Do you have any pain or injuries/conditions that may effect your movements in any way?
Are you currently pregnant or have you recently given birth in the last 6 months?
If you have been pregnant before, did you experience any of the following?
Have you had any recent surgeries that we should know about?

LIABILITY WAIVER:

I declare that I am over 18 years of age (or have otherwise provided parental consent and acknowledge and understand that I Have voluntarily chosen to participate in the classes and activities offered by Pilates with Marie.

I acknowledge and agree that the workouts are a recreational sports activity and may involve strenuous physical activity including, but not limited to stretches, lifts, use of props, use of reformer machines, Pilates chair and that I am not obliged to perform, nor am I obliged to participate in any activity that I do not wish to do, and that it is my right to refuse such participation at any time during classes.

I understand that there are inherent risks in all aspects of physical exercise and I acknowledge that I have been informed of the possible strenuous nature of training.  I agree that prior to my participation I will inform Pilates with Marie of any known medical conditions of factors that may place me at risk.  Pilates with Marie may request a medical release from my medical practitioner prior to participation.  I will inform Pilates with Marie of any symptoms before, during and after participation.

I also understand that if I am a prenatal or postnatal client, I must consult with my physician and receive clearance to perform physical exercise.

I agree to hold harmless and indemnify Pilates with Marie and its employees and agents from any and all liability for any damage to the property of, or personal injury to, any third party, resulting from my participation in any program, activity or service provided by Pilates with Marie.  If any portion of this agreement is held invalid, I agree that the remainder of the agreement shall remain in full force and effect.

In checking the box below I agree that I have not experienced any injury, back, neck or joint pain, restricted movement, heart issues, asthma, or high or low blood pressure, arthritis, slipped or bulging vertebral disk, pelvic floor conditions, dizziness, diabetes, epilepsy, hernia, bone degeneration, high cholesterol , allergies or chronic illness.  I also declare that I have notified Pilates with Marie if I am pregnant and/or have given birth in the last 12 months, or if I have undergone surgery in the past 12 months.

If any of the above health conditions apply to you, please include full details in this form.

Pilates with Marie shall not undertake any obligation to advise or treat me in relation to any of the matters referred to in the preceding paragraph.  I acknowledge that it is my obligation and mine alone to take responsibility for my health and wellbeing during any type of exercise I undertake with Pilates with Marie.

I voluntarily agree to forgo participation in attendance at Pilates with Marie if I have symptoms related to COVID-19 including but not limited to cough, shortness of breath, fever, chills, muscle pain, soar throat, and new loss of taste or smell.  I acknowledge the contagious nature of COVIS-19 and voluntarily assume the risk that I may be exposed to or infected by COVID-19 by attending Pilates with Marie and that such exposure may result in personal injury, illness, permanent disability, and death;

By checking this box below, I acknowledge that Pilates with Marie shall not be liable or responsible to me for articles lost, damaged.

I have read the above release form and waiver of liability and fully understand its contents.  I voluntarily agree to the terms and conditions stated above.

I acknowledge that this waiver may be pleaded in response as a bar to any legal proceeding taken by me or on my behalf.

All persons under 18 years of age must have a Waiver of Liability signed on their behalf by a parent or guardian before attending Pilates with Marie class.  Once the parent or guardian has signed the waiver, persons under 18 years of age may attend Pilates with Marie classes.

I certify that I have read and understand this waiver, have provided it voluntarily, and intedn it to be enforceable to the maximum extent permitted by law. I agree that if any part of this waiver is declared invalid, the rest of this waiver will continue in full force and effect.
All the information given is true and correct and I have provided Pilates with Marie with all the information about my health and wellness that may restrict my ability to perform a class
I agree that my body is my responsibility and i will let my instructor know if I experience any pain or discomfort during the class
I acknowledge that if the instructor feels that I am unfit to particiapate in the workout, they will request I discontinue the workout

TERMS & CONDITIONS:

We recommend you consult with a physician before starting this or any exercise program.  If you experience any pain or discomfort during the course of the program, stop exercising immediately and seek medical attention.  Pre-natal and post-natal clients must consult with their physician and have received verbal clearance to perform physical exercise.

CANCELLATION POLICY:

Any and all scheduled appointments or classes must be canceled by notifying Pilates with Marie a minimum of 24 hours in advance.  We understand that there are last-minute emergencies and cancellations may not be avoided; therefore each client gets one free last-minute cancellation per purchased package.  After that, no-show appointments or late cancelations will be charged in full. 

 

There are no exceptions to this policy.

Thanks for submitting!