Transform Pilates Studio, Inc.                   Client Registration Information Form
Please complete the form below in its entirety.
Sign in to Google to save your progress. Learn more
Email *
Full Name *
Birth Date *
Address *
Cell phone number *
Cell phone company used (ex. AT&T, T-mobile, etc) *
Name and phone number of emergency contact (Include both) *
How did you hear about us *
Have you previously done Pilates on the reformer, and if you have, how long ago? Where did you attend? *
I acknowledge that I am participating in Pilates/TRX Instruction voluntarily and that I understand and am aware that the strength and flexibility exercises associated with Pilates/TRX Instruction are potentially hazardous activities that I undertake at my own risk. *
I assume all risk and responsibility for my participation in Pilates/TRX Instruction and I do hereby declare that: (a) I have had a physical examination by my physician, and/or (b) I have been given my physician’s permission to participate, or (c) I have elected to participate in Pilates/TRX Instruction without the approval of my physician.   *
I do hereby declare that I am physically sound and suffer from no condition, impairment, disease or other illness that prevents my participation. *
Please identify any and all relevant health conditions for informational purposes only below (i.e., back pain or back injury, sciatica, osteopenia, pinched nerve, neck pain or neck injury, osteoporosis, hernia, c-section, abdominal surgery, etc.). *
To be able to participate in a Reformer Pilates class, I must wear pilates socks (socks with grips on the sole), and bring a small towel.  Socks are available for purchase at the studio. *
To be able to participate in a TRX Suspension Training class, I understand I must wear sneakers, and bring a small towel and bottle of water. *
If you are pregnant, please identify how many weeks. If you are not pregnant, please respond "N/A." *
I understand and acknowledge that I must pay for classes at the time of service and I will be charged the value of one class if 24 hour notice is not given when cancelling. I agree that when purchasing a series or package of classes, I am committed to using all classes within 90 days from purchase or I will forfeit the unused classes. I understand if I am more than 10 minutes late and there is a client waiting to get into that class, I may lose my spot. *
By signing below, I hereby waive and release, indemnify, hold harmless and forever discharge Transform Pilates, Inc. and its agents, employees, contractors, officers and owners from any and all claims, demands, expenses, causes of actions, lawsuits, damages and liabilities, of every kind and nature, whether known or unknown, in law or equity, that I ever had or may have arising from or in any way related to my participation in Pilates Instruction or any activities conducted by or on the premises of Transform Pilates, Inc.  On behalf of myself, my heirs, assigns and next of kin, I waive all claims for damages, injuries or death sustained by me that I may have against the aforementioned released party.  I assume all risk and take full responsibility for personal injury, death or damaged property that may occur while I am participating in Pilates/TRX or any other group or private instruction. *
I sign this document of my own accord and certify that I have read it and understand the contents. *
I certify that I am at least 18 years of age and am legally authorized to sign this waiver on my own behalf, or I have obtained the signature of my parent or legal guardian. *
I certify that the above responses are true and correct and that any dishonest answers may have serious public health or medical implications. I understand this is a continuing obligation and I further agree to update the responses to this waiver if there are any changes. If you agree and accept, please type your full name as your electronic signature below. *
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy