• COEUR New Client Form + Liability Waiver

    Please complete this client intake form and review the liability waiver carefully before signing. Provide accurate health, movement, and emergency contact information.
  • Participant Information

  • Format: (000) 000-0000.
  • Date of Birth*
     - -
    2 digit month, 2 digit day, 4 digit year
  • Format: (000) 000-0000.
  • Movement + Health Information

  • Have you practiced Pilates before?*
  • Are you currently pregnant or recently postpartum?*
  • Movement Background

  • What are you hoping to get from your Pilates or fitness practice? Select all that apply:*
  • ASSUMPTION OF RISK, RELEASE OF LIABILITY & AGREEMENT NOT TO SUE

    PLEASE READ CAREFULLY

    Participation in COEUR Activities
    I voluntarily choose to participate in services, programs, and activities offered by Coeur LLC, doing business as COEUR ("COEUR"). These activities may include, without limitation: Pilates instruction, including Reformer, Tower, Chair, mat, and other apparatus-based movement; group classes, private sessions, semi-private sessions, workshops, and educational programs; personal training; strength training; mobility and functional movement training; conditioning and general fitness exercise; use of Pilates apparatus and fitness equipment; and use of strength-training and gym equipment, including weights, dumbbells, kettlebells, resistance bands, benches, platforms, balls, props, and similar equipment. These services are collectively referred to as the "Activities." COEUR may also offer optional wellness and recovery services. Certain wellness or recovery services may require an additional informed consent or waiver before participation.

    1. Voluntary Participation and Assumption of Risk
    I understand that participation in the Activities involves physical exertion and inherent risks. These risks may include, but are not limited to, muscle soreness, strains, sprains, falls, loss of balance, aggravation of a pre-existing injury or condition, contact with equipment or other participants, equipment malfunction or misuse, dizziness, fainting, abnormal blood pressure or heart rate, cardiovascular events, and other bodily injury. I understand that some risks may be foreseeable and others may be unexpected. I voluntarily choose to participate and knowingly assume the risks associated with my participation in the Activities.

    2. Equipment Use
    I understand that COEUR Activities may involve the use of Pilates apparatus, spring-based equipment, strength-training equipment, weights, resistance equipment, benches, platforms, props, and other fitness equipment. I agree to follow instructor directions regarding equipment setup, spring or resistance selection, safe entry and exit, exercise technique, proper positioning, and use of props and equipment. I agree not to use equipment in a manner I do not understand and to ask an instructor or COEUR team member whenever I am unsure how to use equipment safely. I understand that COEUR may modify or restrict my use of equipment when necessary for safety.

    3. Health and Physical Condition
    I understand that it is my responsibility to determine whether I am physically able to participate in the Activities I choose. I represent that I am not aware of any medical condition, injury, physical limitation, or other circumstance that would make my participation unsafe unless I have disclosed that information to COEUR. I understand that I am responsible for informing my instructor of any injury, pregnancy, recent surgery, medical condition, pain, dizziness, or other circumstance that may affect my participation. If my physical condition changes, I agree to notify COEUR before continuing to participate. I understand that COEUR and its instructors and staff do not provide medical diagnosis, medical treatment, or medical advice. If I have questions about whether an Activity is appropriate for me, I understand that I should consult an appropriate healthcare professional.

    4. Responsibility During Exercise
    I understand that I am responsible for working within my own abilities. I agree to stop an exercise and notify my instructor if I experience pain, dizziness, unusual shortness of breath, weakness, nausea, discomfort, or another concerning symptom. I understand that instructors may provide modifications, alternatives, or recommend that I not perform a particular exercise. I understand that no particular physical, fitness, aesthetic, therapeutic, or medical outcome is guaranteed.

    5. Physical Contact and Instruction
    I understand that Pilates, personal training, and fitness instruction may occasionally involve physical contact for purposes such as positioning, alignment, cueing, safety, or assisting with equipment. I may decline physical contact at any time by informing my instructor.

    6. Release and Waiver of Liability
    To the fullest extent permitted by Washington law, I voluntarily release, waive, and discharge Coeur LLC, COEUR, and their owners, members, managers, employees, instructors, contractors, agents, representatives, successors, and assigns from claims for bodily injury, property damage, or other loss arising out of or relating to my participation in the Activities, including claims arising from the ordinary negligence of a released party. I understand that by signing this agreement I am giving up certain legal rights, including the right to bring certain claims or lawsuits against COEUR. This release applies only to the fullest extent permitted by Washington law.

    7. Personal Property
    I understand that COEUR is not responsible for loss, theft, or damage to personal belongings brought into the studio.

    8. Workshop, Class, and Personal Training Participation
    I understand that classes, workshops, and training sessions are educational and fitness-based. Exercises may be modified, substituted, progressed, regressed, or omitted based on my individual needs, abilities, safety considerations, available equipment, or the instructor's judgment. I understand that participation in one class, workshop, or session does not guarantee that I will be prepared to perform every exercise independently.

    9. Studio Rules and Safety
    I agree to follow reasonable studio rules, equipment instructions, and safety directions provided by COEUR staff and instructors. I understand that COEUR may ask me to discontinue an exercise, leave a class, or stop using equipment if staff reasonably believe continued participation may create a safety risk to me or others.

  • Participant Acknowledgments

  • Electronic Signature

  • Date*
     - -
    2 digit month, 2 digit day, 4 digit year
  • Should be Empty: