Have a sneak preview of my one of pregnancy Pilates workouts:

Have a sneak preview of one of my postnatal Pilates workouts:

For those of your with fussy eater who won't eat vegetables: can you guess what the hidden vegetable in here is? Tried and tested: kids love i...

Mums who do my classes spotted this award and said I should go for it. http://t.co/kiVJ8KEE5a

Registration Form

Course: *
First Name: *
Last Name: *
Date of Birth: *
Email Address: *
Confirm Email Address: *

Address Line 1: *
Address Line 2:
Town: *
County: *
Postcode: *
Mobile Number: *

If pregnant, please state your due date:

If you have had a baby within the last 12 months please state when:

Please state type of delivery: *

Emergency contact details

Name: *
Mobile Number: *

Medical Questionnaire

Has your doctor ever said that you have a heart condition? No Yes

If YES, please give details:

Do you feel pain in your chest when you do any physical activity? No Yes

In the past month, have you had chest pain when you were NOT doing physical activity? No Yes

Do you lose your balance because of dizziness or do you ever lose consciousness? No Yes

Do you have a back, pelvic or other joint problem that could be made worse by a change in your physical activity? No Yes

If YES, please give details:

Do you suffer from raised blood pressure? No Yes

If YES is this pregnancy related and how is it being treated?

Do you suffer from diabetes? No Yes

If YES, is it pregnancy related and how is it being treated?

Do you suffer from asthma? No Yes

If YES, how do you control it?

Do you suffer from haemodynamically significant heart disease? N/A No Yes

Do you suffer from restrictive lung disease? N/A No Yes

Have you been told that you have an incompetent cervix/cerclage? N/A No Yes

Are you expecting twins? N/A No Yes

If yes, have you been told that you are at risk of going into premature labour? N/A No Yes

Have you been getting persistent bleeding? N/A No Yes

Are you over 26 weeks pregnant and have you been told that you have placenta praevia (a low placenta)? N/A No Yes

Are you suffering from pregnancy-induced hypertension (pre-eclampsia)? N/A No Yes

Have your membranes ruptured? N/A No Yes

Do you know of any other reason that could affect your participation in exercise? No Yes

If YES, please give details:

Are you a regular exerciser? No Yes

If YES, please give details:

Do you intend to do any other exercise in addition to this programme? No Yes

If YES, please give details:

Have you had your post natal check up? No Yes

Was everything satisfactory in your post natal check up? No Yes

If NO, please give details:

Informed Consent

A group fitness programme has been designed for you, taking into account your health and activity levels. It may involve cardiovascular work, core stability training, and a mixture of indoors and outdoors activity.

All activities will be explained and demonstrated where necessary. Please feel free to ask questions about any part of the programme. Any exercise programme carries with it an element of risk. This programme is designed in such a way as to minimise the risk whilst conveying maximum training benefit to assist you in achieving your goals.

Please inform me if for any reason you should not participate in a particular exercise, or of any injury that you have which may be aggravated by exercise. If at any time during a class you feel undue pain or excessive discomfort, you should stop the exercise and inform me.

I agree to take part in the Zest4lifeUK course that I have signed up for and I understand that the programme will change and progress over the 10 weeks. The nature, purpose, risks and benefits have been explained to me.

I warrant that I have made a full and correct disclosure of my health status on the Medical Screening Questionnaire, that my status has not changed since the aforementioned disclosure and that I am not aware of any adverse medical condition in myself which Zest4lifeUK would expect me to reveal.

I understand that Zest4lifeUk does not bear any liability for personal injury however caused to any persons, including but not limited to myself as a result of my participation in this programme. Zest4lifeUK recognises that liability as a result of negligence cannot be excluded.

Participant's Name: *

Witness Name: *

By checking this box you agree to zest4lifeuks consent form and confirm that all answers are correct.

How did you find us: *

Online food shopping

Get ready to "survive" motherhood with this guide to online food shopping and how to eat healthily when you have no time!

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