Pre and Post Natal Waiver Form

First name

Last name

Email

Baby's name and DOB (if applicable)

Please confirm that if bringing a baby they are under the age of 6 months and not crawling.

Yes

No

Have you (the mother/guardian) received medical clearance from your GP or healthcare provider to begin or resume physical activity, including Pilates?

Yes

No

Has your baby been given a clean bill of health by a medical professional to attend this class environment (i.e. group setting with physical movement)? * If not applicable please tick yes.

Yes

No

Are you currently experiencing, or have you recently experienced, any of the following conditions: severe abdominal pain, bleeding, dizziness, high blood pressure, pelvic pain, or other postnatal complications?

Yes

No

Are you aware that all exercise involves a risk of injury, and by participating in this class, you do so at your own risk?

Yes

No

Do you acknowledge that P.I.LATES accepts no liability for any injury or condition sustained by you or your baby as a result of participating in the class?

Yes

No

Do you understand that in the event your baby becomes unsettled and you need to leave the class early, no refunds or class credits will be issued? * If not applicable please tick yes.

Yes

No

Do you understand that it is your responsibility to stop any exercise if you feel unwell or uncomfortable, and to inform the instructor of any concerns?

Yes

No

Do you understand and accept that P.I.LATES and its instructors are not medically trained and cannot diagnose or treat any condition?

Yes

No

Do you agree to follow the safety instructions and modifications provided by the instructor to ensure appropriate participation?

Yes

No

Do you confirm that you are voluntarily participating in the class and have disclosed any relevant medical or physical information that may affect your ability to exercise safely?

Yes

No

I understand that participation in any fitness class, including Mother & Baby / Pre and Postnatal Pilates, involves inherent risks. I confirm that both myself and my baby are in good health, have been cleared by a GP or healthcare provider to participate, and that I take full responsibility for our participation. I hereby release P.I.LATES, its employees, and contractors from any liability for injuries, illnesses, or loss (to person or property) incurred while participating.

Signature

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