New Client Form

Please fill out prior to your first Pilates class.

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Phone Type
Have you participated in a Pilates program before?

Demographics

Please check the appropriate boxes below or fill in the other field.

Activity Based
Aged Based
Health Based

AGREEMENT OF RELEASE & WAIVER OF LIABILITY

I hereby agree to the following:

Client is aware that participation in a sport or health and fitness class, such as The Pilates Method of Exercise utilized by Core Pilates and Wellness, may result in accident or injury, an adverse medical reaction or condition, and even possible death, and Client further represents that the Client assumes the risks connected with their participation in The Pilates Method of Exercise. The Client is in good health and suffers from no physical impairment, which would limit his or her use of Core Pilates and Wellness Studio facilities or participation in The Pilates Method of Exercise.

Client acknowledges that Core Pilates and Wellness has not and will not render any medical services, including medical diagnosis of the Client’s physical condition. Client specifically agrees that Core Pilates and Wellness , its officers, employees, agents, representatives shall not be liable for any claim of negligence or strict liability, or any type of cause of action of any kind whatsoever for, or on account of death, personal injury, property damage or loss of any kind resulting from or related to Clients use of the premises. Further, Client agrees to hold Core Pilates and Wellness harmless from any such claims of action.

I have read this release and waiver of liability and fully understand its contents. I understand that I am waiving any right to bring a legal action to assert a claim against Core Pilates and Wellness and or an instructor for negligence. I voluntarily agree to the terms and conditions stated above.

Thanks for submitting!