Registration Form for Children

Consent *

I confirm that I am the legal guardian/parent of the client mentioned below I consent for the client mentioned below to participate in Clinical Equipment Pilates at Complete Pilates I understand that the below client is U16 and it is my responsibility to pay in advance for the said client

I confirm that the below-mentioned client is aged between 13-16 years and give my consent for them to attend sessions on their own without a legal guardian/parent present. *

Yes No

I confirm that the client mentioned below is under the age of 13, and a legal guardian or parent will attend the entire session. *

Yes No

General information

Name *

Date of birth *

Sex *

Male Female Other

Contact telephone number for legal guardian / parent *

Contact email for legal guardian / parent *

Medical information

Is the client currently seeking medical attention for any injury, illness or pain? *

Yes No

If yes please give details below *

Please give details below of current activity levels of the client *

Please tick if the client has any of the following medical conditions *

No medical concerns Diabetes Asthma Epilepsy Heart conditions Lung disease Osgood-Schlatters Disease Diagnosed spine conditions Sever’s disease Any other

Diagnosed spine conditions - If yes please give details *

Any other (please give details) *

Please accept the below policies *

I have read the terms and conditions I understand the cancellation policy I understand the privacy Policy

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FORMS

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0203 764 5668

EMAIL US

Angel Clinic Business Design Centre 52 Upper Street Angel London N1 0QH

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London City Clinic Lower Ground floor 37-39 Lime Street London EC3M 7AY

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Chelsea Clinic First Floor 321 Fulham Road London SW10 9QL

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Norfolk Clinic Unit H Creake Abbey North Creake Fakenham Norfolk NR21 9LF

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© Copyright 2025 - | Designed and Maintained by JID | All Rights Reserved Complete Pilates Medical Ltd registered in England & Wales at 115 Hampstead Road, London, NW1 3EE (for correspondence only), company number: 10206019. Complete Physio Ltd registered in England & Wales. 18 Church Hill, Winchmore Hill, London, N21 2JB (for correspondence only), company number: 05926168

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