Pregnancy Pilates- Health screening form

Health screening | Registration Form- Pregnancy Pilates

This form only needs to be filled out once, prior to attending your first class. *If you are attending a PILATES SCULPT (pregnancy safe) Class inside MAXI FIT, please skip question 14*
1. Full name

Име
2. Mother's date of birth

MonthDayYear
Date
3a. Phone number

Area CodePhone Number
3b. Which contact method do you prefer?
4. Email Address
example@example.com
5. Estimated date of birth:

DayMonthYear
6. Have you experienced any of the following
7. How many pregnancies have you had? Counting this one
8. Does your regular occupation (work or home) include:
9a. Emergency contact

First NameLast Name
9b. Emergency contact- Phone number
Please enter a valid phone number.Format: (000) 000-0000.
10. Classes
📍Варна Одесос, бул. Xристо Ботев 10, 9000 Varna (Floor 1- Unqiue studio)

There are directions in the confirmation text, you will receive this once your form has been reviewed
11a. Pilates experience
11b. Physical activity history
12. How did you hear about the class?
If you were referred by a friend, you can put there name here. They will receive a gift !💝
13. Do you consent to being in photography & videography, and this content to be used on social media and marketing?
Skip this section if you are attending Maxi Fit classes
14a. Once your form has been reviewed, you will receive a payment link- via text/email
14b. Depending on the options you select, you will automatically receive an SMS with the payment link.
Should be Empty:

Health screening | Registration Form- Pregnancy Pilates