Thank you for your interest in our services. Advanced registration is required for all classes. You will receive a confirmation mail from us. Inspire Mum & Baby Registration Form (Aqua Classes) Date of registration: 2/6/2012 Pls select the class/ service you are enrolling: Aqua Pregnancy @ Simei (AP-LT) Saturdays - S$170 InspireBaby Aqua @ YMCA (LT-YBA 01) Monday - S$133.75 InspireBaby Aqua @ Private Individual - S$500 InspireBaby Aqua @ Simei (LT-BA.SM-S945) Saturday - S$125 InspireBaby Aqua @ Private Group - S$125 InspireMum Aqua Pilates @ Private - S$170 InspireMum Aqua Pilates @ YMCA Singapore (AP-Y01) Friday - S$203.3 InspireMum Aqua Pregnancy @ YMCA (LT-YA01) Monday - S$181.9 InspireMum Aqua Pregnancy @ Private Individual - S$550 InspireMum Aqua Pregnancy @ Private Group - S$185 InspireMum Aqua Pregnancy @ YMCA (LT-YA03) Saturdays (except 18 Feb) - S$181.9 InspireMum Aqua Yoga @ Private Group - S$170 InspireMum Post-Natal Aqua @ Private - S$170 InspireTots Aqua @ YMCA (LT-17) Saturdays - S$155.15 InspireTots Aqua @ Private Group - S$145 Clients’ Particulars: Name: Mr Ms Mrs Mdm Nationality: NRIC: Race: Date of birth: Occupation: EDD (for pregnancy only): Relationship to Child (Baby classes): Address: Home Contact: Mobile: Email: In Case of Emergency: Person to contact: Relationship: Contact number: Baby/Child's Particulars: (If applicable): Name: Age: Gender: Male Female Date of birth: Medical Conditions: (If any): Any special instructions/ Medical Conditions: Have you joined any similar course before? No Yes If yes, pls indicate the level: Beginner Intermediate Advanced Type: Est Date: How do you hear about this course? Magazine - Please specify Newspapers - Please specify Internet - Please specify Flyers Friends Walk in Others - Please specify Would you like to be in Inspire Mum & Baby mailing list? No Yes Any other areas of interest? Mode of payment: Cash Credit Card Cheque Strictly no video and photo taking during classes at all times unless granted with permission. THINGS TO BRING All students is advised to bring their own goggles Water bottle is recommended for continuous hydration. Towel Non-slip slippers Toiletries Sunscreen lotions is recommended for adults and babies Non-slip mats (InspireBaby® Aqua classes only) All registrants will need to read these T&Cs before the class. GENERAL CONDITIONS All Aqua students need to shower (next to swimming pool) prior to the class In the event of infections, sickness, students are not allowed to attend the class. No refund for any cancellation You are encouraged to seek consent from your doctor (especially for pregnancy) before taking the classes. Any special/medical conditions are required to be notified before the class. Please note the Aqua classes are not swimming lessons and all students need to keep your own safety as the first priority. In any event of discomfort, inform the instructor immediately. All medical conditions to be stated prior to the class All students to be in proper swimming attire No jewellery allowed at all times except for wedding bands, studs that will not cause injury. All long hairs to be tied properly All students to stay close to the group AT ALL TIMES In the event of sudden rain midway through the class, no replacement will be done. There are no makeup class for aqua classes INSPIREMUM™ AQUA PREGNANCY Moms-to-be to attend after 12weeks of pregnancy All students to be gentle with their body and not to overstretch themselves in the pool. Please seek your doctor's consent if possible before the class To wear the thermal warmer if possible in case of cold INSPIREBABY® AQUA & INSPIRETOTS™ AQUA You are required to stay with your child at ALL TIMES. Do not allow your child to run around in the poolside Do not allow your child to eat in the pool All babies and toddlers need to wear a swimming diaper at all times during the class. In the event of soiling, the mum will be responsible for cleaning up/ pay for the liabilities. We encourage a good pool diaper protection to prevent soiling in the pool. Do not throw your child around the pool Do not attempt to dive your child into shallow pool All babies/ toddlers' ears to be cleaned right after the class. Tap them from side to side to remove any potential access water. Moms with long nails to be careful while managing the children in the water CLASS CANCELLATION The session will be cancelled and not counted as a paid session in the event of: Rain on the actual day for regular classes. All students will be informed at least 1 hour prior to the class. Instructor absence due to sickness/urgent matters Public Holidays For private and private group classes only The session will be cancelled and not counted as a paid session if the instructor is notified at least 1 day before class. The session will be cancelled and counted as a paid session in the event of: The class informs the instructor LESS THAN 45mins prior to the official class timing. ˝ session fee per pax will be deducted. In the event of ˝ session deduction from course fee, the class can choose to top up or deduct from the sessions package. The parent coordinating the group/ individual informs the instructor LESS THAN 15 mins prior to the official class timing. Full session fee per pax will be deducted. QUESTIONNAIRE Please read the questions carefully and answer each one honestly. If you knowingly give incorrect information, the instructor can bear no responsibility for any resultant injury or pain. Yes No Questions Has your doctor ever said that you have a heart condition and that you should only do physical activity recommended by a doctor? Do you feel pain in your chest when you do physical activity? In the past month, have you had chest pain when you are not doing physical activity? Do you lose your balance because of dizziness or do you ever lose consciousness? Do you have a bone or joint problem that could be made worse by a change in your physical activity? Is your doctor currently prescribing drugs (for example, water pills) for your blood pressure or heart condition? If you answer YES to any of the above questions, you are required to obtain your doctor's written permission BEFORE attending a course. Are you a swimmer? If no, are you phobia of water? Class changes: Some classes require a minimum number of registrants to commence. Should there be any changes to the lesson schedules, registrants will be notified at least 1 week before the start date. As Inspire Mum & Baby is closed during all Public Holidays, any classes falling under these dates will automatically be moved to the same day of the following week. Inspire Mum & Baby reserves the right to change the schedule/ timing/venue of the classes and merging of classes if deemed fit. Disclaimer of warranties, limitation of liabilities & indemnification: Inspire Mum & Baby Pte Ltd will not be responsible for any losses, injuries or mishaps or any third party claims for all services and products rendered. You agree to indemnify and hold harmless "Inspire Mum & Baby Pte Ltd" from any claims resulting from your use of the services or products. You expressly agree that use of the product or service is at your sole risk. Neither Inspire Mum & Baby nor its service providers, agents, licensors, employees shall have any liability for any damages suffered by you or any other third party claims as a result of the use or misuse of the services and products provided. Validity: There is no make up for any packages. In the event of public holiday, instructor unwell, or advance notice from studio management, the class will postpone accordingly. I hereby agree to the terms and conditions stated in this form.