Pilates for Sisters | Al-Khaadem

Please be advised that this activity is for SISTERS ONLY

PERSONAL DETAILS

Name*

Please enter your Full Name (As per IC / Passport)

Age*

Phone*

Email*

Emergency Contact*

Phone Number

Is this your first time registering for this programme?

HEALTH QUESTIONNAIRE

Please tick what aspect(s) of your health you would like to concentrate on:*

Select All
Core stability
Flexibility
Posture
Strength
Stress Management
Relaxation

Does your occupation involve any repetitive movements or prolonged postures?*

No
Yes

Do you compete in any sporting activity?*

No
Yes

Have you ever had an episode of back pain?*

No
Yes

Have you recently had any injuries or surgery?*

No
Yes

Are you pregnant?*

No
Yes

How many weeks are you?*

When is your due date?*

Please tick any of the following conditions that you are currently experiencing (if any):

Lower back pain
Anaemia
Pelvic pain
Bronchitis
Any other spinal pain
Joint replacements
Heart problems
High or low blood pressure

Please tick any of the following conditions that you have been diagnosed with or had treatment for (if any):

Asthma
Arthritis
Osteoporosis
Diabetes
Cancer
Depression
Epilepsy
Dermatitis
Stroke

BOOK YOUR SLOT

Activity

Instructor*

Price per class: RM40

Book your slot*

Please note that you are able to book your slot for multiple dates at a time.

September 2024

Mon	Tue	Wed	Thu	Fri	Sat	Sun
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2	3	4	5	6	7	8
9	10	11	12	13	14	15
16	17	18	19	20	21	22
23	24	25	26	27	28	29
30

Price

RM 0.00

Total

RM 0.00

Payment Method*

Please transfer the total amount to: 5623 5711 4347 FOQUS AKY SDN BHD (Maybank)

Keep the payment slip and upload it below:

Upload Proof of Payment*

Max. file size: 128 MB.

TERMS & CONDITIONS

NEW NORMAL

We will be observing the following SOP in accordance to what has been set by the authorities:

Only registered attendees can enter
All attendees must wear face masks
Scan “Selangkah” QR code before entering
Get temperature checked by staff in charge (Must be below 37.5°C)
Maintain social distancing (1 metre) - avoid handshakes and body contact
Stand on the designated line while queuing
Wash hands / Use the hand sanitizer provided before entering

Please note that we have the right to refuse admission if:

Attendee fails to follow our SOP
Attendee body temperature exceeds 37.5°C
We have reached maximum capacity for the day

Agreement to terms & conditions*

I hereby acknowledge that I have read, understood, and agree to all that have been stated and that all the information I have given is true.

1. Your placement is only confirmed when payment is fully paid
2. Placement is by first come first serve basis
3. Any payment made will not be refunded
4. Upon confirmed registration and payment, we will email you the confirmation and receipt
5. Please read the following Liability Form
6. For hygienic purposes, please bring your own mat (we have a limited amount of mats to lend)
7. You will adhere to the New Normal SOP set by Al-Khaadem at all times whilst being in our centre
8. For further clarification please contact Sis Raihan Zafrul via WhatsApp: +60184699271