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Welcome! To help design a safe, effective, and deeply personalized Pilates practice tailored to your body, please complete this intake form before your first session.

General Information

Birthday
Month
Day
Year

Name, Relationship to you, Phone Number

Medical & Health History

Please check any of the conditions that apply to you:

Body Awareness & Movement Baseline

Fitness & Pilates Experience

Have you practiced Pilates before?

Goals & Intentions

What are your primary goals for your Pilates practice? (Check all that apply):

Liability Waiver & Informed Consent

Please read carefully before signing.

1. Voluntary Participation & Assumption of Risk: I, the undersigned, understand that participation in Pilates instruction, fitness training, and somatic movement—including the use of specialized apparatus such as the Reformer, Cadillac, Wunda Chair, and various resistance springs or props—involves inherent risks of physical injury, muscle strains, joint sprains, falls, or other accidents. I acknowledge that these risks cannot be entirely eliminated, and I knowingly and voluntarily choose to assume all risks associated with my participation.

2. Representation of Physical Health: I affirm that I am in good physical condition and do not suffer from any medical condition, impairment, or disease that would limit or prevent my safe participation in these sessions. I acknowledge that it is my sole responsibility to consult with a physician prior to beginning any new exercise regimen. I agree to monitor my own physical condition throughout every session and will immediately inform the instructor of any pain, discomfort, dizziness, or changes in my health status.

3. Release of Liability & Covenant Not to Sue: In consideration for being permitted to participate in these sessions and utilize the studio facilities, I hereby release, waive, discharge, and hold harmless ViviPilates, its instructors, employees, and independent contractors from any and all liability, claims, demands, or causes of action arising out of ordinary negligence, accidental injury, or property damage sustained during, or as a result of, my participation. This includes, but is not limited to, injuries resulting from physical exertion, equipment malfunction, slipping or falling within the studio premises, or the instructor’s hands-on tactile cueing and physical adjustments.

I expressly agree that this release is intended to be as broad and inclusive as permitted by law, and that if any portion is held invalid, the remainder shall continue in full legal force and effect.

I have carefully read this waiver and fully understand its contents. I am aware that by signing this document, I am waiving certain legal rights, including the right to sue for accidental injury.

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24-Hour Cancellation Policy

Your session time is reserved exclusively for you. Because personalized instruction requires dedicated scheduling and preparation, we enforce a strict 24-hour cancellation policy.

  • Policy Terms: Any cancellation, rescheduling request, or missed appointment made less than 24 hours before your scheduled session start time will result in a full charge for the session (or the forfeiture of that session credit from your package).

  • No Exceptions: We understand that sudden illnesses, family emergencies, unexpected work conflicts, and transport issues happen to everyone. While we are deeply empathetic to these unfortunate circumstances, we are unable to waive this policy for any reason, under any circumstances.


Why we enforce this strictly: As a boutique studio, our instructors reserve this time solely for you, making it unavailable to clients on our waitlist. This policy ensures we can maintain a predictable schedule, honor our commitment to our instructors' time, and continue providing the highest quality of focused, dedicated care to all clients.

By signing below, I acknowledge that I have read, understood, and agree to abide by the 24-Hour Cancellation Policy without exception.

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