Schedule Appointment with Willow Tree Pilates

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First Name *

Last Name *

Phone *

Your E-Mail Address *

Notes to Business (your address or any special notes about your order)

Item	Quantity	Total
Single Private Session - Equipment and/or Mat		$95.00
Total: $95.00	Coupon:

Pilates sessions and packages are non-refundable except in the case of changes in medical condition resulting in physical limitations (physician letter required). I understand the terms of this form. I agree to be financially responsible to pay for charges incurred from cancellations made less than 24 hours or no shows. I authorize Willow Tree Pilates to charge my account in the event of a late cancellation or no show.