Thank you for choosing the Pilates Institute of Maryland for Pilates Information and Instructor Training.
This form will be used to register for the Pilates Instructor Training
and the Pilates, Joseph, H. Workshop only.
To register for the Pilates Instructor Training or Pilates, Joseph, H. Workshop, please complete and sign the form below.
Name: _____________________________________________________
Address: ___________________________________________________
Phone number: ____________________(home) __________________(work or cell)
Email: ___________________________
Emergency contact: _____________________________ Relationship: __________
Location and date of the Training or workshop you have choosen to attend: ___________________________________________________________________________
Participation Waiver
I acknowledge that there are certain dangers inherent in any physical fitness activity including participation in a Pilates Training or Workshop. I hereby for myself, my heirs and my assigns, waive any and all claims to damages I may have against Jo-Ann Giles, the Pilates Institute of Maryland (PIM), its officers, employees, Darryl Giles, the facility at which the workshops are held, any agent or representative of any of the preceding for any and all injuries suffered by me while traveling to, from and participating in this event. The Pilates Institute of Maryland and Jo-Ann Giles recommends that all participants seek individual consultation with a physician of their choice before engaging in any physical fitness activity, including the Pilates Institute of Maryland's Pilates Instructor Training and any other workshops by the Pilates Institute of Maryland and/or Jo-Ann Giles. To the best of its knowledge, the Pilates Institute of Maryland and Jo-Ann Giles' knowledge, the information and techniques to be presented at the Pilates Instructor Training and any other workshops by PIM, are accurate. However, the Pilates Institute of Maryland and Jo-Ann Giles disclaims any responsibility for the individual use or application of such information or techniques by the participant. Due to weather, presenter illness, travel mishaps or any other situation out of the Pilates Institute of Maryland or Jo-Ann Giles control, the Pilates Institute of Maryland and Jo-Ann Giles reserves the right to reschedule any Training or workshop. I understand that I may be videotaped, audio recorded and photographed during the event and the Pilates Institute of Maryland and Jo-Ann Giles may use the image for any and all uses.All payments are non refundable unless the event is cancel by PIM or natural disaster. Having signed below where indicated, participant acknowledges and agrees to the foregoing.
Signature: ______________________________________ Date: _____________________
Please return this form with payment (check or money order please) to:
Pilates Institute of Maryland
PO Box 44702, Fort Washington, Maryland 20749-0702
Questions? JoAnnGiles@verizon.net or call 301 257 4819
Thanks again :-)