Client Waiver
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Email *
Full Name *
Date of Birth
Please note: we do not accept clients under 18.
 *
MM
/
DD
/
YYYY
Phone number *
Emergency Contact Full Name *
Emergency Contact Phone Number *
Health History (Check all that apply) *
Required
Describe any injuries, limitations, or concerns *
Have you done Pilates within the last year?
Clear selection
If yes, what kind? 
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