Pre-Exercise Screening Form (Pregnancy)

All information given will be confidential.

Emergency Details

Pregnancy History

Informed Consent & Disclaimer

I, the undersigned acknowledge that in normal circumstances exercise should not harm my baby or I in any way. I shall inform my instructor of any medical or pregnancy related changes prior to commencing any class and that The Pilates Corner, nor the instructor will not be held liable in any way for any unforeseen circumstances or for any circumstances of which I should have been aware, but failed to notify them. I give permission to staff of The Pilates Corner to contact any of the emergency contact numbers set out above should the need arise. 

I have read the above statement and agree to be bound by it and to release The Pilates Corner Ltd from all claims.

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