Step 1 of 3 33% Contact InformationName* First Last I identify my gender as*MaleFemaleDate of Birth* Date Format: MM slash DD slash YYYY Address* Street Address Suite/Apt. No. City AlbertaBritish ColumbiaManitobaNew BrunswickNewfoundland and LabradorNorthwest TerritoriesNova ScotiaNunavutOntarioPrince Edward IslandQuebecSaskatchewanYukon Province Postal Code Phone*Email* How did you find us?FacebookBlog TOFriendOtherPlease specify preferred hours to attend classes* Medical HistoryLast medical checkup*Less then 1 month ago1 - 3 months ago3 - 6 months agoMore then 6 months agoHow many pregancies have you had?*None1234More then 4Have you ever been seriously injured? Do suffer from aches or pains, recent or previously?*NoYesPlease describe your injuries/aches/pains and include dates*Has your doctor said that you may exercise?*YesNoOther heath concerns? Examples: asthma, diabetes, osteoporosis, high blood pressure, medications, surgery.Are you currently seeing any other healthcare professionals? Example: massage therapist, physiotherapist, chiropractor, naturopath. Please include names.Are you involved in any regular physical activity?Have you had any previous training in Pilates and/or yoga?*NoYesWhere did you train and how long?* What are your goals and what would you like to get out of our program?*What services are you interested in? Check all that apply* Group classes Private classes Semi-private classes Workshops What is your instructor preference?* Female Male Undistinct How should we contact you?*PhoneEmailPhone or EmailWhen is the best time to call you?*During regular business hours (9am - 5pm)Before noon (9am - 12pm)After noon (12pm - 5pm)Evening (5pm - 7pm)Terms & Conditions* I have read and agree to the terms & conditions as stated in the Studio Policies. (Opens in a new window.) PhoneThis field is for validation purposes and should be left unchanged.