Your Name (required)

Your Email (required)

Your Phone (required)

Preferred method of contact
PhoneEmail

If Phone, best time to call:
MorningAfternoonEvening

I am interested in (check all that apply):
Private Sessions – 1 on 1 w/ TeacherEquipment Classes – 5 student maxMat/Barre Classes – 10 student maxBodhi Suspension Training ClassesPilates for MS / Neurological IssuesPilates Teacher TrainingBodhi Suspension Teacher TrainingI don’t know

Fitness Goals (check all that apply):
Weight Loss / ToningStrengthSport PerformanceRange of Motion / FlexibilityBalance

Availability for Practice (check all that apply):
Early Morning (5:00-7:30am)Morning (8:30-11:30am)Afternoon (12:00 – 3:30pm)Evening (4:30 – 8:30pm)

How Often Do you Wish to Practice:
1 time per week2 times per week3 times per week4 or moreI don’t know

Current Activity Level (over the past 6 months):
Not ActiveModerately Active (exercise 1-3 times per week)Very Active (exercise more than 3 times per week)

Physical Limitations or Injuries (If yes, please describe)?

If answered yes to Physical Limitations above, do you have your physician’s consent to practice Pilates?:
YesNo