You have indicated that you do, or may have an injury or illness that may restrict your ability to do a class with us. Please fill out the form below and provide as much detail as possible.

Your information will be securely kept in the strictest confidence and shared only with the instructors that are required to know this information to be able to help you.

Do you have any health or medical problems? Please let us know about all conditions* *
Do you have any pain or injuries/conditions that may effect your movements in any way?* *
Are you currently pregnant or have you recently given birth in the last 6 months?* *
Have you had any recent surgeries that we should know about? *

Waiver of Liability and Prospective Release Form for Pilates On Collingwood Street

I declare that I am over 18 years of age (or have otherwise provided parental consent) and acknowledge and understand that I have voluntarily chosen to participate in the classes and activities offered by Pilates On Collingwood Street.

I acknowledge and agree that the classes are a recreational sports activity and may involve strenuous physical activity including, but not limited to stretches, lifts, use of props, use of reformer machines, strenuous bodyweight exercises and other strenuous activities that I am not obliged to perform, nor am I obliged to participate in any activity that I do not wish to do, and that it is my right to refuse such participation at any time during classes.

I understand that there are inherent risks in all aspects of physical exercise, and I acknowledge that I have been informed of the possible strenuous nature of classes. I agree that prior to my participation I will inform Pilates On Collingwood Street of any known medical conditions or factors that may place me at risk. Pilates On Collingwood Street may request a medical release from my medical practitioner prior to participation. I will inform Pilates On Collingwood Street of any symptoms before, during and after participation in a Pilates On Collingwood Street class.

I also understand that if I am a prenatal or postnatal client, that I must consult with my physician and receive clearance to perform physical exercise.

I release Pilates On Collingwood Street and its staff, employers and relevant parties from any and all liability for any loss, damage, injury or expense that I may suffer, or that my next of kin may suffer as a result of my participation in the classes, activities and services provided by Pilates On Collingwood Street.

In checking the box below I declare that I have advised Pilates On Collingwood Street of any injury, concerns, medical conditions or any other relevant factors. I also declare that I have notified Pilates On Collingwood Street if I am pregnant and/or have given birth in the last 12 months, or if I have undergone surgery in the past 12 months.

If any of the above health conditions apply to you, please include full details in this form.

I acknowledge that it is my obligation and mine alone to take responsibility for my health and wellbeing during any type of exercise I undertake with Pilates On Collingwood Street.

By checking this box below, I acknowledge that Pilates On Collingwood Street shall not be liable or responsible to me for articles lost, damaged or stolen from the studio.

I understand that from time to time Pilates On Collingwood Street and/or its employees or contractors may film or photograph the classes, activities or services provided by Pilates On Collingwood Street. By checking the box below, I permit Pilates On Collingwood Street to use, publish, reproduce, distribute, my image, either complete or in part, alone or in conjunction with any wording, for uses including publicity and/or merchandising and/or editorial purposes, in any manner and in all forms of media whether now existing or developed in the future. I hereby waive any right to inspect and approve the photographs or videos or the printed/digital/electronic matter that may be used in conjunction with them now or in the future, regardless of whether that use is known or unknown. I waive any right to copyright or royalties or other compensation from or related to use of the photography or videos or adaptations thereof.

I have read the above release and waiver of liability and fully understand its contents. I voluntarily agree to the terms and conditions stated above.

I acknowledge that this waiver may be pleaded in response as a bar to any legal proceeding taken by me or on my behalf.

Please note: terms and conditions of this release form and waiver of liability are subject to change without notice.

All persons under 18 years of age must have this form signed on their behalf by a parent or guardian before attending a Pilates On Collingwood Street class. Once the parent or guardian has signed the waiver, persons under 18 years of age may attend classes.

I agree to the above waiver *
All the information given is true and correct and I have provided Pilates On Collingwood Street with all the information about my health and wellness that may restrict my ability to perform a class *
I agree that my body is my responsibility and I will let my instructor know if I experience any pain or discomfort during the class *
I acknowledge that if the instructor feels that I am unfit to participate in the workout, they will request I discontinue the workout *