Client Registration Form Name Age Mobile Phone Number Email Address Class that you are registering for Do you have any illnesses or injuries YesNo If yes, please give details Do you require GP Clearance for excercise? YesNo Have you done Pilates before? YesNo If 'Yes' please let us know where: How did you hear about us? FacebookInstagramGoogleWord of mouthOther If 'Other' Please let us know where: Please tick if you would like to receive a text message when our new courses are open for booking I understand that I must inform my instructor, before any class, if I have received an injury, have been recently unwell, or have become pregnant. (For In-studio or outdoor classes) I confirm that neither I, nor any member of my household, have traveled abroad within the last 14 days and I am not currently under quarantine advice. I have not been in close contact with any person that has been diagnosed with COVID-19 or any person that has been advised to quarantine in the last 14 days . I do not currently experience from any of the common COVID-19 symptoms (high temperature, dry cough, tiredness). Furthermore, I will immediately inform The Pilates Studio Midleton if I, or any member of my household begin to experience any of the aforementioned common COVID-19 symptoms. Submit
