New Member Form

Enter your details in the form below prior to your first class or private session.

Pilates House is passionate about providing you with personalised service and working with you to achieve your individual goals. Providing us as much information as possible in the form below, allows us to tailor our services to members needs and assists our instructors to ensure all exercises consider any injuries or conditions of attendees.

You only need to complete this form once, prior to your first class, and all details provided are completely confidential, as outlined in our Privacy Policy.  Please ensure you view our Terms and Conditions and Cancellation Policy.

Name *
Address *
Health Conditions *
Please check if "yes" for any of the following health conditions
Do you take any medications that may affect you whilst exercising? *
Do you experience any undiagnosed pain? *
Do you have any of the following joint problems, pains or injuries?
Please check if "yes" for any of the following areas
Have you been referred by an allied health practitioner / medical professional?
Have you been advised against exercise or certain exercises? *
Are you currently pregnant? *
Do you have any health conditions associated with pregnancy?
Have you been pregnant in the last 3 months?
Have you consulted with your doctor before participating in physical exercise?
Which classes are you most interested in attending?
Please tick all that apply
Which times do you prefer to attend classes?
Please tick all that apply
Informed consent / waiver of liability *