I have read and completed this questionnaire and confirm that I have fully understood and answered the questions honestly and I take full responsibility for my health whilst doing Breeze Pilates On Demand. I understand that Carol Little cannot be held responsible for any injuries or ill health arising from my participation in the Breeze Pilates On Demand.

I have read and understood the Breeze Pilates On Demand Privacy Policy at the time of completing this form and consent to my data being used for the purpose of delivering Pilates classes, workshops and retreats.

I am happy to receive e-mails regarding information relevant to Pilates with Breeze Pilates On Demand.

Please advise of any changes in your health, where you would now answer YES to one of the above questions.