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Tell us a little about you and we’ll confirm your class on WhatsApp.

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About you

Required fields are marked with an asterisk.

Name & Surname Age & Date of Birth Occupation Contact number Emergency contact name & number Physical address Other physical activities or sports? Referred by

Health & goals

This helps Vicky keep you safe in class. It stays private.

Injuries, weaknesses or problem areas Reason for joining & what would you like to achieve? Medication

Your classes Joining studio and will attend:

Private Pilates Duet Pilates Group Pilates class ×1 Group class Pilates ×2 Group class Pilates / stretch ×3–4 Other

Have you attended a private Pilates intro session at the studio?

Yes No

I will pay via

Cash EFT

Please note. Classes attended, props and equipment used are at your own risk. The studio and instructor may not be held liable for any injury or damage caused during a session. Fees are payable monthly or per session. There is a 12-hour cancellation policy — classes not cancelled or rescheduled within that time will be charged. Please inform your instructor how you are feeling before the class, and let them know if you are unable to attend. There is a degree of physical contact between you and your instructor.

Your acknowledgement

I have read and acknowledge I have read but have concerns

Your information (POPIA). The studio stores the details on this form to manage your classes and to contact you in an emergency. We do not sell or share them. You may ask us to delete them at any time.

I consent to the studio storing this information.

Please tick the consent box to continue.

Rather ask on WhatsApp

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The Dynamic Body Studio · 12 Strangers Way, Dorchester Heights, East London