In order to have a safe and enjoyable workout, please complete Forms 1-3 before your first class. I'll review your information and we'll discuss any health concerns you have.
Form 4 is optional, but I recommend you fill it out too. All information is kept strictly confidential. Please ask me if you have any questions about privacy or procedures.
1. Student Contact Information
Please fill out this form carefully. Who would we call if got injured?
2. Statement of Informed Consent
Release of Claims and Insurance Affidavit Please fill out and sign this form in the presence of a family member or friend.
3. Medical History
I teach low impact classes that are easily modified to meet your needs. However, if you have any important medical issues, (pregnancy, surgery, diabetes, heart or back problems, etc.), please let me know before purchasing a Package or joining a Class.
4. Personal Fitness & Wellness Goals
What are your self-care goals and how will you achieve them? Please take a few minutes to complete this form for yourself- to share with me or not.
Learn more about Nia Cardio Dance
Founder & Owner
Lake City private bedroom/bath in home available January 2018