Intake form

Name *

First Name

Last Name

Home Address *

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Phone *

(###)

###

####

Birthday

*You can expect a birthday gift from us!

MM

DD

YYYY

Describe your level of pilates experience *

None

Some

Lots

Please read the following and check the boxes for your acceptance *

I understand Union Pilates Inc. has a 24 hour cancellation policy regardless of circumstance or illness. If I do not cancel my scheduled lesson 24 hours in advance I will be charged in full.

I understand that all expiration dates are clearly stated. The start date is the first day of purchase. (Let us know if you need an adjustment). All packages are non-refundable and non-transferable. Any package can be put on hold for circumstances such as illness or vacation if notice is given in advance.

I practice personal responsibility and attend at my own risk. By choosing to attend class at Union Pilates, even with increased safety measures, I acknowledge and accept the additional risks associated with the COVID-19 Global Health Pandemic.

I understand cell phones must be silenced and kept out of the movement space. (If there is an emergency situation, please inform your teacher prior to the start of your lesson.)

Union Pilates Policies *

• All In-Studio Lessons and classes are 50 minutes in length. The hour begins at the scheduled appointment time, not at time of arrival.
• All VIRTUAL Classes & Appointments are 50 minutes in length.
• Please arrive on time. For your physical safety and respect of fellow classmates, students arriving later than 10 minutes after the start of a group class will not be permitted to join.
• Form fitting attire should be worn, preferably black, so proper corrections can be made. No shoes are allowed in studio space. Bare feet preferred.
• Insurance billing is not available - receipts only.
• The studio reserves the right to assign a substitute teacher.
• All lessons and classes must to be paid in advance.
• Please notify us of any changes in your health/ medical condition.
• If a duet student cancels with more than 24 hours notice, their partner must also cancel or choose to pay for and attend a private lesson.
• If a duet student cancels with less than 24 hours notice, they will be charged in full. Their partner may still attend at their regular duet rate.
• Please arrive no more than 5 minutes prior to your start time and be respectful of volume in the waiting area while classes are in session.
• A '1 Month' Membership is defined as 4 weeks.

I have carefully read, fully understand, and agree to the above.

Emergency Contact *

First Name

Last Name

*

Phone

(###)

###

####

Waiver Addendum *

My signed Union Pilates Inc. liability waiver applies to all Union Pilates Inc. services including but not limited to in-studio services, remote services and online and virtual services.

I Agree