STOTT PILATES® Course Application

We will be in touch with you after we review your application.

Name*
Address*
Home Phone Number*
Cell Phone Number*
Are you a new or existing NEP student?*
Email Address*
Would you like to receive our emails about courses and workshops?*
Which course(s) would you like to apply for?*
What is/are the start date(s) of the course(s) you would like to take?*
Please list any relevant degrees, diplomas, and/or certifications:*
Please describe your education in anatomy:*
Please list your experience teaching dance, movement, group exercise, or coaching:*
Please describe your Pilates experience.*
What is your STOTT PILATES® Instructor's name?*
If you are a new student, your STOTT PILATES® Instructor must send us a Letter of Reference to karen@northeastpilates.com. Have you asked him/her to do so?*
Please list the STOTT PILATES® courses you have taken (if any). Include dates and locations.*
Do you have any injuries, conditions (including current or recent pregnancy), or postural challenges that may impact your performance in the course you plan to take?*
Students cannot miss the first day/weekend of any course. Are you able to attend all dates of the course? If no, which dates can you not attend and why? Contact the Education Department for details and costs for making up missed hours.*
Please read and agree to our cancellation policy.*
Tuition for Northeast Pilates courses and workshops is non-refundable.

If NEP has to cancel for any reason, a full refund will be returned to the applicant or the applicant can choose to apply payment to another course.

If you need to cancel 25 days or more prior the the course date, tuition (less deposit) is transferred to a future education course or workshop of your choice.

If you cancel less than 24 days before the start date of a course, your tuition is non-refundable and non-transferable.

Once a student starts a course, there will be no refunds or transfers unless we have a written doctor's letter stating medical necessity. In this instance, we will offer a transfer to another course up to one year after the original course.
Please read and agree to our liability release:
Praxis Performance & Wellness, Inc. and PJ O'Clair, Inc. d/b/a Northeast Pilates Education Centers, hereafter known as NEPEC, shall not be liable for any damages arising from any personal injuries sustained by a guest, client, or student on or about the premises of NEPEC or a Hosting Facility. A guest, client, or student using NEPEC or Hosting Facilities and equipment does so at his/her own risk. A guest, client, or student assumes full responsibility for any injuries or damages with may occur to him/her using said facilities and he/she does hereby fully and forever release and discharge NEPEC or Hosting Facilities, its owners, employees, and agents from any and all claims, demands, damages, rights of action or causes of actions, present or future, whether the same be known or unknown, anticipated or unanticipated, resulting from or arising out of a guest's, client's, or student's use or intended use of NEPEC or Hosting Facilities and equipment.

I warrant, represent, and agree that I am in good physical condition and have no disability, impairment, ailment, or pregnancy preventing me from engaging in active or passive exercise or that will be detrimental to my health, safety, comfort, or physical condition if I do so engage or participate. NEPEC or Hosting Facilities shall not be liable for the loss of, theft of, or damage to the personal property of a guest or member.

I agree to keep and obey all of the rules and regulations now in force or prescribed by NEPEC and its Hosting Facilities for the use of its facility and equipment.
By typing your signature on this application you certify that you have provided all true statement and agree to our terms.*
Date*
Notes or questions for the Education Department

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