Welcome to the world of Aerial Arts!

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I am so excited to begin working with you as your Aerial Coach!

For your convenience, all of our initial "paperwork" is included below. The following online form should take you less than 15 minutes to complete.

Email *

PART 1: PERSONAL INFORMATION

Full Name *

Postal Address

Phone Number *

Date of Birth *

YYYY

Emergency Contact (name and phone) *

PART 2: PAR-Q

This form acts as a PAR-Q (Physical Activity Readiness Questionnaire) that will help determine whether or not it's safe for you to begin a new exercise program. Please answer the following questions honestly, and provide as much detail as possible where applicable.

Has your doctor ever said that you have a heart condition and that you should only do physical activity recommended by a doctor? *

Yes

Do you feel pain in your chest when you do physical activity? *

Yes

In the past month, have you had chest pain when you were not doing physical activity? *

Yes

Do you lose your balance because of dizziness or do you ever lose consciousness? *

Yes

Do you have a bone or joint problem (for example, back, knee or hip) that could be made worse by a change in your physical activity? *

Yes

Is your doctor currently prescribing drugs (for example, water pills) for your blood pressure or heart condition? *

Yes

Do you know of any other reason why you should not do physical activity? *

Yes

If you answered YES to any of these questions, please explain in detail here:

PART 3: LATE/NO-SHOW/CANCELLATION AGREEMENT

Just as would be the case if you were working with a personal trainer at a gym or a nutritionist in a medical office, the following expectations must be met with regards to our coaching sessions:

1. Single class bookings - £15.50 - can be cancelled or rescheduled with 72 hours notice or more. Sessions that are not cancelled or rescheduled more than 72 hours in advance will result in forfeiture of the session. The full fee will remain payable.

2. 4 class pass - discounted rate of £12.50 per class, all classes to be used within a 4 week period - Sessions booked cannot be cancelled or rescheduled. These sessions are non refundable.

3. Clients arriving late to a coaching session will receive the remaining scheduled session time, unless other arrangements have been previously made. Clients that are later than 15 minutes will be considered a no-show and not permitted to take part in the class (as they will have missed the warm up) - the full fee will remain payable.

I have read the above Cancellation Agreement and agree to its terms: *

Yes

Required

PART 4: WAIVER OF LIABILITY

It's important that you understand that any form of physical exercise can be strenuous and subject to risk of serious injury. You are urged to obtain a physical examination from a doctor before participating in any exercise activity, including those provided by Nicole Pearson.

You agree that if you engage in any physical exercise or activity, you do so entirely at your own risk. This waiver and release of liability includes, without limitation, all injuries which may occur as a result of: (a) your participation in any activity or participation in any exercise routine and (b) instruction, training, supervision, or dietary recommendations by Nicole Pearson.

You acknowledge that you have carefully read this “waiver and release” and fully understand that it is a release of liability. You expressly agree to release and discharge Nicole Pearson from any and all claims or causes of action and you agree to voluntarily give up or waive any right that you may otherwise have to bring a legal action against Nicole Pearson for personal injury or property damage. By signing this release, you acknowledge and understand its content and that this release cannot be modified orally.

I have read the above Waiver of Liability and agree to its terms: *

Yes

Required

PART 5: FINAL THOUGHTS & SIGNATURE

Is there anything else you'd like to share? If so, please do so here:

I agree that all information provided on this form is accurate to the best of my knowledge: *

I agree

Required

Type your full name here as your digital signature: *

If under 18, please have a parent or guardian type their full name here as their digital signature:

Signed on: *

YYYY

Send me a copy of my responses.

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