Health form Healthform Step 1 of 5 20% First name(Required) Surname(Required) Date of birth(Required) DD slash MM slash YYYY Addresss(Required) Mobile phone number(Required)Emergency contact person (name + relationship)(Required) Emergency contact Number(Required)Can you briefly describe your previous and current exercise activities?(Required) Are you currently pregnant?(Required) Yes No You can attend sessions up until 16 weeks pregnancy.Pregnant Clients: Have you obtained clearance to exercise from your doctor? (must obtain prior to commencement of pilates class)(Required) Yes No Pregnancy waiver(Required) I agree to the pregnancy waiverI acknowledge that I am currently pregnant and that I have voluntarily chosen to participate in Pilates classes during my pregnancy. I understand that certain exercises and movements involved in Pilates may pose risks during pregnancy, including but not limited to strain, muscle soreness, and other potential injuries. I hereby agree to release and discharge Proform Pilates, its instructors, and any associated staff from any and all claims, demands, or causes of action that I may have against them, including, but not limited to, those relating to any pregnancy-related complications or injuries that may arise during or after the Pilates classes. I acknowledge that it is my responsibility to consult with a healthcare provider before beginning any exercise program during pregnancy. I further agree to inform the Pilates instructor of my pregnancy and to disclose any specific limitations or precautions provided by my healthcare provider. I understand that it is crucial to listen to my body during the Pilates class and to refrain from any exercises that cause discomfort, pain, or any adverse effects during my pregnancy. I also agree to follow all instructions provided by the Pilates instructor and to use any equipment or props provided with caution and in accordance with the provided guidelines. I hereby affirm that I am participating in Pilates classes during my pregnancy of my own free will and that I am fully aware of the potential risks involved. I assume full responsibility for any and all injuries or complications that may arise as a result of my participation. I have read this waiver and fully understand its content. I voluntarily agree to its terms andDo you have children?(Required) Yes No Please list their agesDo you have any conditions that may require special consideration for you to exercise?(Required) Yes No Please explain more about those conditionsDo you have any Allergies?(Required) Yes No What allergies do you have?Do you have a history of injury / operations / accidents?(Required) Yes No Tell us more about your history of injuriesDo you have any muscle, bone or joint pain or soreness that made worse by particular types of activity?(Required) Yes No Please tell us what types of activitiesAre you currently taking any prescribed medication (other than those already mentioned) for any other medical conditions?(Required) Yes No (please note you are required to bring any medication to class if required for physical exercise and alert your trainer to this prior to commencing physical activity)Tell us more about your prescriptions Have you been told you have any of the following conditions (please tick if it applies) High blood pressure High cholesterol High blood sugar levels Have you have spent time in hospital (including day admission) for any medical condition/ illness/ injury in the past 12 months Arthritis Osteoarthritis Osteoporosis Abdominal disorders or bloating Carpal Tunnel Syndrome (wrist/finger/hand/ forearm including pain and/or numbness and/or tingling) Incontinence Prolapse Caesarean wound discomfort or ongoing numbness Separation of your abdominal muscles (DRAM) Breast health/ mastitis within the last 3 months Please provide further detail What do you want to achieve with Pilates? Liability Waiver(Required) I agree to waiverI hereby acknowledge and agree to my participation in the Pilates classes conducted by Proform Pilates. I understand that Pilates involves physical movements and exertion, which may be strenuous and may cause physical injury. I am fully aware of the risks and hazards involved. I agree to assume full responsibility for any risks, injuries, or damages, known or unknown, which I might incur as a result of participating in each class. I hereby waive, release, and discharge any and all claims for damages for personal injury, death, or property damage which I may have or which may accrue to me as a result of my participation in the Pilates classes. I hereby release Proform Pilates, its instructors, employees, agents, and representatives from any and all liability, claims, demands, actions, and causes of action whatsoever, arising out of or related to any loss, damage, or injury, including death, that may be sustained by me, or to any property belonging to me, while participating in the Pilates classes. I understand that it is my responsibility to consult with a physician prior to and regarding my participation in a Pilates class. I certify that I am physically fit, have sufficiently prepared, and have not been advised to not participate by a qualified medical professional. I acknowledge that this Liability Waiver will be used by Proform Pilates and that it will govern my actions and responsibilities during my participation in the Pilates classes. I agree that this Liability Waiver shall be governed by and construed in accordance with the laws of Queensland, Australia. I have read this Liability Waiver thoroughly and understand its terms and I execute it voluntarily and with full knowledge of its significance. I acknowledge that to the best of my knowledge all the information I have supplied in this form is true and correct. Δ