Client Enrolment Form

All information will be treated in the strictest confidence. Your details will be added to MINDBody to set up an online account to manage your classes and to Constant Contact to update you with studio and term news, if you are happy for us to contact you. Your details will not be passed onto anyone else.

Date of birth

Emergency Contact Details

Your background and your health

Will this be the first time that you have practised pilates?
Has your doctor ever said that you have any sort of heart trouble or defect?
Do you feel pain in your chest when you undertake physical activity?
Are you or could you be pregnant now?
If yes, when is your due date?
Have you been pregnant in the last 6 months?
If you have had a baby, how was it delivered
Do you often get headaches?
Do you lose your balance because of dizziness or do you ever lose consciousness, feel faint or dizzy?
Do you have high blood pressure?
Is your blood pressure
Have you had major surgery in the last 10 years?
Have you had minor surgery in the last two years?
Do you suffer from asthma, diabetes or epilepsy?
Have you ever been told you have arthritic joints, osteoporosis, osteopenia or any bone or joint problem that may be made worse by exercising?
Do you suffer from back or neck pain?
Do you have pain or restricted movement in any other joints (eg: hip, knee, ankle, shoulder)?
Have you ever been diagnosed as hypermobile (excessive joint mobility)?
Are there any movements that cause you pain?
Are you taking any drugs or medication which may affect your ability to excercise?
Have you ever been recommended to take up Pilates by a specialist practitioner?
If YES, by your:
Do you hereby give us permission to contact them?
If YES, please state their name and contact number:
Anything else we need to know:

Please inform us before commencing any session, if for any reason your health or ability to exercise has changed. It is inadvisable to exercise between weeks 8 to 14 of your pregnancy, except by special arrangement with your teacher. You should not restart until you have been signed off your GP at your 6-8 week check.

These sessions are not a substitute for medical counselling or treatment. If you have any doubts about an exercise being unsuitable refer back to your medical practitioner/GP. The teacher can accept no liability for personal injury related to participation in a session if : Your doctor on health grounds has advised against it.
You fail to observe instructions or safety advice.
Such injury is caused by the negligence of another participant.

I understand that Pilates will involve some hands on correction and I hereby consent to this.

Make up classes are only available where at least 24 hours to cancel a class is provided, have to be taken during the current term and where there is space available.

There are no refunds. If you are unable to complete a term due to medical reasons a credit for another term will be provided.

Please sign below to confirm your understanding and acceptance of these terms.

Are you happy for us to contact you with studio news / updates?
Signed and dated:

Find us

The studio is within a 5 minute walk of Twickenham Rail Station, there is ample car parking at Waitrose, York House, Flood Lane and on street in the evenings as well as pay and display on the surrounding roads. Numerous buses stop on the High Street and we are also fortunate to have lots of cycle parking at both ends of Church Street and by the Mary Wallace theatre.

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20 Church St.

The studio is within a 5 minute walk of Twickenham Rail Station, there is ample car parking at Waitrose, York House, Flood Lane more...