SW Cali Workshop Booking Form

1
Name* This field is required.
First Name
Last Name
2
Phone Number* This field is required.
Area Code
Phone Number
3
Email* This field is required.
example@example.com
4
What workshop will you be attending?* This field is required.
5
How did you hear about this Workshop?
Friend
Social Media
SW Cali WhatsApp
Other
6
If you’re on social media, what’s your Instagram username?
7
Name* This field is required.
First Name
Last Name
8
Phone Number* This field is required.
Area Code
Phone Number
9
Relationship to you
10
Has your doctor ever said you have a heart condition or should only do physical activity recommended by a doctor?* This field is required.
YESNO
11
Do you ever feel pain in your chest when performing physical activity?* This field is required.
YESNO
12
Do you ever experience chest pain when you are not physically active?* This field is required.
YESNO
13
Do you lose balance because of dizziness or ever lose consciousness?* This field is required.
YESNO
14
Do you have a bone, joint, or back problem that could be made worse by exercise (e.g. wrist, shoulder, neck, or spine)?* This field is required.
YESNO
15
Are you currently taking any medication that may affect your ability to exercise safely?* This field is required.
YESNO
16
Are you pregnant, or have you given birth in the last 6 months?* This field is required.
YESNO
17
Do you know of any other reason why you should not take part in physical activity?* This field is required.
YESNO
18
If you answered YES to any question, please give details below:
Huge
Large
Normal
Small
Ok
Ok
19
I have completed the PAR-Q form honestly and understand it is my responsibility to consult a healthcare professional if I have any concerns.
YESNO
20
I understand physical activity carries risks. I’m responsible for my own safety and will stop if I feel unsafe. I release SW Cali, its coaches, and volunteers from liability except in cases of gross negligence or unlawful acts.* This field is required.
YESNO
21
I consent to SW Cali using photos/videos of me for promotional purposes (e.g., social media/website).* This field is required.
YESNO
22
I agree to respect all participants, follow safety instructions, and use equipment responsibly during the workshop.* This field is required.
YESNO
23
Agreement Date* This field is required.
Date
Day
Month
Year
24
Workshop Payment* This field is required.Please select one and pay with the methods below to confirm your order
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ORDER SUMMARY
Total costGBP
Handstand Workshop (Standard)
Adults only
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Total cost
Payment Methods
Credit Card
First Name
Last Name
Google Pay
After submitting the form, you will be redirected to the Google Pay to complete the payment process.
Apple Pay
After submitting the form, you will be redirected to the Apple Pay to complete the payment.
Clearpay
After submitting the form, you will be redirected to the Clearpay to complete the payment process.
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