Name
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First Name
Last Name
Phone Number
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Email Address
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How did you hear about Aligned Athletics?
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What is your current exercise routine?
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What are your goals?
Are your currently taking any medication?
Have you been to physical therapy in the last 12 months?
If yes, please explain here
Hypertension?
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Pregnancy:?
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Osteoporosis?
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Weight Loss or Gain?
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Heart Disease?
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Broken Bones?
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If yes, please explain below.
Previous Surgeries?
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If yes, please explain below.
By initialing below I release Danielle Clark and all Aligned Athletics staff from all claims pertaining to my participation in all Pilates, Yoga, GYROTONICS and FST group classes or private training sessions. I am, to the best of my knowledge, both physically and mentally able to enlist in all training programs. I acknowledge that I am aware of my right to consult an attorney before signing this waiver and release. I am aware that I am agreeing to take part in an exercise program and that I should consult my physician before starting an exercise program.
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By initialing below I acknowledge that I'm, to the best of my knowledge, free from any disease/condition that would prevent you from participating in a Yoga, Pilates, Gyrotonics and FST session with Danielle Clark and all Aligned Athletic Staff Members.
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By initialing below you acknowledge that all private lessons require a 24 hour cancellation. An appointment can be cancelled via email at alignedathletics@gmail.com. If you cancel a session with less than 24 hours before it, we will work with you to reschedule the session, but will not be able to refund the lesson.
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