Pilates Mat at Town Stages
Sign up for Pilates at Town Stages!
Once you submit this form, please send your payment. Your registration is complete once your payment is received. Venmo- @movewithjam



Questions/comments/concerns? movewithjam@gmail.com

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I'm coming to class on Monday, 12/17/18 at 8:30am! *
First name: *
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Last name: *
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Phone number (will only be used for last-minute changes) *
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Any injuries/pain I should know about? *
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Cancellation Policy: I understand that if I do not cancel my registration with at least 24 hours notice, I will not be refunded for the class. *
I understand that I must submit payment in order to complete my registration. *
Payment can be sent via Venmo- @movewithjam . If you do not have Venmo, please email me at movewithjam@gmail.com for other options.
I understand that I am participating in Pilates and/or other methods of movement offered by Jamila Youngstedt, during which I will receive information and instruction about Pilates, and/or other methods of movement and bodywork. I recognize that this involves physical exertion which may be strenuous and may cause physical injury, and I am fully aware of the hazards involved. I understand that it is my responsibility to consult with a physician prior to and regarding my participation in Pilates and/or other methods of movement. I represent and warrant that I am physically fit and have no medical condition which would prevent my full participation. I agree to assume full responsibility for any risks, injuries or damages, known or unknown, that I may incur as a result of participating in the sessions. I knowingly, voluntarily and expressly waive any claim I may have against Jamila Youngstedt for injury or damages that I may sustain as a result of participating in classes. I, my heirs or legal representatives forever release, waive, discharge and covenant not to sue the instructor for any injury caused by their negligence or other acts.
I have carefully read this Release and Waiver and fully understand and voluntarily agree to the above. *
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