Health disclosure and booking form
To book Pilates classes in Teddington with Bemore, please print this form (File>Print), complete and return to us at the address below with your payment alternatively contact us via mb: 07981 193 677 or email robyn@alkamie.co.uk
About you
Name Address
Phone
Email
About your health

Please tell us if you have relevant health problems that you think we need to know (e.g. back, neck, knee injuries)

What classes you would like to book
Day Time Description Number of places
6 class pass
(£60 each)

Single places
(£12 each)

Wednesday 6.30-7.30pm Relaxation Pilates    
7.30-8.30pm Dynamic Pilates    
I enclose a cheque for a total made payable to Robyn Stuart and agree that this is non-refundable (unless the course is cancelled) Total
Please print (File>Print), complete and mail with your cheque to: Brian & Robyn, Bemore c/o 93 Lawrie Park Gardens, Sydenham London SE26 6HW or email to info@alkamie.co.uk
We look forward to seeing you at the class