New Member Form

Enter your details in the form below prior to your first class or private session.

Exhale Pilates is passionate about providing you with personalized service and working with you to achieve your individual goals. Providing us as much information as possible in the form below, allows us to tailor our services to members needs and assists our instructors to ensure all exercises consider any injuries or conditions of attendees.

You only need to complete this form once, prior to your first class, and all details provided are completely confidential, as outlined in our Privacy Policy.  Please ensure you view our Terms and Conditions and Cancellation Policy.


Please complete and submit the form below before your first class or session.

Name *
Name
Mailing Address *
Mailing Address
Phone *
Phone
I would like class/appointment reminder sent to... *
Date of Birth
Date of Birth
Emergency Contact *
Emergency Contact
Emergency Contact Phone *
Emergency Contact Phone
Health Conditions *
Please check box if "yes" to any of the following health conditions
Do you take any medications that may affect you while exercising? *
Do you have any of the following joint problems, pains or injuries? *
Please check if "yes" for any of the following areas
Have you been referred by a health practitioner / medical professional? *
Have you been advised against exercise or certain exercises? *
Are you currently pregnant? *
If you answered yes, have you consulted with your doctor before participating in physical exercise? *
Please provide a letter of release from your obstetrician or birthing coach.
Which classes are you most interested in attending? *
Please check all that apply.
Which times do you prefer to attend classes? *
Please check all that apply.
Informed consent / waiver of liability *
Please check all the boxes below. *
By checking all the boxes you are agreeing to our policies and terms.