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Intake Form


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Intake Form

To better serve your health and fitness needs, we ask that you complete this form:




Please list previous and current activities/exercises you participate in?





Please answer the following questions related to lifestyle and nutrition:








WAIVER & CONSENT FORM

CANCELLATION POLICY: I UNDERSTAND THAT I MUST CANCEL A SCHEDULED APPOINTMENT. I MUST NOTIFY EVERY BODY PILATES AT LEAST 24 HOURS IN ADVANCE OR I WILL BE HELD RESPONSIBLE FOR A PAYMENT IN FULL.

I have enrolled in a program of instruction in the Pilates Method of physical conditioning, Redcord Suspension Exercise, Strength Training, Functional Movement, Personal Training and/or Nutrition Coaching offered by Every Body Fitness-Pilates, Inc. I understand that the use of exercise equipment also carries with it a risk of injury. I recognize that many changes may occur as a result of these exercise lessons, including possible short-term aggravation of some symptoms, feelings of tiredness, light-headedness, increased energy, mood changes, etc. I also understand the activities are designed to place a gradual increasing workload on the musculoskeletal, flexibility, metabolic, and/or cardio respiratory systems to assist in their function, which may change my blood pressure and heart rate.

I also understand that a medical evaluation is advisable before commencing any program of physical conditioning, nutrition coaching, or exercise. I have and will continue to keep Every Body Pilates fully informed of any physical condition or disability, which would prevent or limit my participation in any exercise or physical conditioning program. I acknowledge that, although the conditioning program I participate in may have substantial physical benefits, neither Every Body Pilates nor its employees are engaged in diagnosing or treating medical diseases or deficiencies.

If I have enrolled in a program of the physical conditioning which is to be conducted by an intern, I have been advised that the student intern conducting the program has not completed the full requirement for certification to instruct at Every Body Fitness-Pilates, Inc. I understand that because the student intern has relatively limited knowledge and experience with instruction, the risk of injury to me may be greater.

I expressly assume all risks of my participation in the programs of exercise, physical conditioning and nutrition coaching conducted by Every Body Fitness-Pilates, Inc., on-site and off-site programs and waive any claim which I might otherwise bring against Every Body Fitness-Pilates, Inc., or Kirstin L. deFrees, its officers, directors, shareholders, employees, trainees and contractors as a result of injuries resulting from or relating to my participation in exercise, physical conditioning and nutrition program.

Every Body Fitness-Pilates, Inc. shall not be responsible or liable for any articles lost, stolen, or damaged, in or about the studio, or off-site locations.

I understand that Mat and Apparatus classes require prior evaluation of my fitness level and that I am responsible for attending the appropriate level class.

In case of instructor illness or emergency, you will be notified as soon as the need for cancellation has been determined. There will be no charge and the lesson will be rescheduled as a result of these circumstances.

I agree to commit myself to this program and to leverage Every Body Fitness-Pilates, Inc. as intended and for no other purpose. I understand the time used to improve my health and well-being is not limited to sessions with Every Body Fitness-Pilates, Inc. and will make a valiant effort to remember any positive results I experience are a direct result of the work and perseverance I have dedicated to my personal health.

July 6, 2020