JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.
Pilates with Laraib
Please complete the questionnaire and our friendly team will reach out to you.
Sign in to Google
to save your progress.
Learn more
* Indicates required question
Email
*
Your email
What is your full name?
*
Your answer
What is your phone number?
*
Your answer
Please confirm that you are aged 18 and over:
*
Confirm
Please tick if any of the following apply to you
*
Slipped/bulging discs
Cardio-vascular disease
Post Partum (less than 6 weeks)
Pregnant
Osteoporosis
Not applicable
Required
What would you like to sign up for?
*
Group Sessions - Thursdays @7.30pm
Weekend Mornings (Mum's Power Hour) TBC
1-1 Sessions (PilatesPlus)
Online Sessions (Virtual Vitality) - TBC
Required
Please note, if you are pregnant or are less than 6 weeks post-partum, the sessions may not be suitable for you. Your safety is my priority.
*
Proceed
Required
Please note, you must inform the instructor (Laraib) if you have any injuries prior to the session starting. This is to ensure your safety and wellbeing.
*
Proceed
Required
How physically active are you?
*
Inactive
1
2
3
4
5
Very Active
Are you new to Pilates?
*
Yes
No
Why are you signing up for Pilates classes? Please also add any comments or preferences here.
Your answer
Submit
Clear form
Never submit passwords through Google Forms.
This form was created inside of laraibm.com.
Report Abuse
Forms
