Private Lesson Form

First name

Last name

Email

Phone

Birthday

Month

Day

Year

Emergency Contact

Do you currently have any injuries or health conditions?

Are you currently pregnant or recently postpartum?

Yes

No

Preferred session pace:

Slow & Control

Moderate

Challenging

Select the options you'd like to focus on:

Flexibility

Strength

Targeting Heart Rate Zones

Other:

Describe here

8. Consent & Acknowledgment:

I understand that Pilates involves physical movement performed on the floor and requires balance, strength, and control.

I confirm that I am physically able to participate and will communicate any discomfort during sessions.

I hereby waive, release, and discharge SOMOS Ent. LLC. from any and all liability, claims, or demands arising from or related to my participation in these sessions.

Anything else we need to know: