Client Waiver
Sign in to Google to save your progress. Learn more
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 before?  *
If yes, what kind? 
Next
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. - Terms of Service - Privacy Policy

Does this form look suspicious? Report

Google Forms