PilogaFit
PilogaFit

PilogaFit  Health Questionaire

Please complete this questionnaire before starting your first class

Confidential

 

Name (Please print) -

Town or Village -

 

PilogaFit class attending -   Wedmore Village Hall    Wednesday   10.30 - 11.30am

The objective of the PilogaFit class is to progressively increase your Core Stability and joint Dynamic Stability. This is to be achieved through low intensity and low impact exercise.

The following is to ensure your safety. If you have any concerns, please contact your GP before starting any exercise class or if you feel unwell during or after.

 

Has your doctor advised against low impact, low intensity exercise ?

Yes

No

 

Please indicate any health conditions your doctor is aware of

-

-

-

 

 

Please indicate any health conditions your doctor is not aware of

-

-

-

 

I understand my physical limitations and will practice safely at my own level.

If I feel ill or pain I will stop immediately. I will then contact my GP.

I will take full resposibility for my health during the class and after.

If necessary, I will ask for modifications of the exercises.

 

 

Signed                                                           Date

 

 

 

Contact us

 

01749 672482

john@clickbeasley.com

News               NEW CORE STABILITY EXERCISE CLASS Any age or ability* Pay as you go. Drop in. No need to book. Just £5 when you attend, not when you don't.           Please bring a mat and try to arrive 10 minutes early. We always start on the dot

Start now

 

WELLS

Connect Centre

MON      5.30 - 6.30pm

THUR    9.30 - 10.30am

 

St Thomas Church Hall

WED       5.30 - 6.30pm

 

SS&L Building

 Fri         12.15 -1.15pm

 

WEDMORE Village Hall

WED     10.30 - 11.30am

 

PROFESSIONALLY QUALIFIED

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