Emergency Contact Information
Brief Health History
* If you are pregnant, or planning on becoming pregnant, please note that it is your responsibility to obtain pre- approval from your doctor or Gynaecologist to participate in classes and any other sessions at Pilates Dynamics Studio.
*By affixing my initial to this form, I declare myself to be responsible for my own health and safety while participating in classes and any other sessions at Pilates Dynamics Studio and thereby release, acquit, discharge, indemnify and hold harmless Pilates Dynamics Studio, its officers, personnel, employees and agents from any and all cause or causes of injury. In addition, Pilates Dynamics shall not be responsible or liable for any articles lost, stolen or damages, in or about the studio.
*By affixing my initial to this form, I declare myself to be responsible for my own health and safety while participating in classes and any other sessions at Pilates Dynamics Studio and thereby release, acquit, discharge, indemnify and hold harmless Pilates Dynamics Studio, its officers, personnel, employees and agents from any and all cause or causes of injury. In addition, Pilates Dynamics shall not be responsible or liable for any articles lost, stolen or damages, in or about the studio.