Booking Form

Please fill in this form prior to a Free Taster session, Workshop, Beginner course, Or each time you move up a level.

Physical Activity Readiness Questionnaire (PAR-Q), Informed Consent Form, GDPR & Media usage Confirmation AND Booking Form.

We need this to allow you access to the building. If you get a lift, add the reg of your ride. If you arrive another way, enter a 0. If we don’t have any reg details for you, you must sign in with the guard upon arrival.
We need to take this for legal reasons only. We do not send you post.
Candy & Chrome do not provide a company telephone number, as email and social media messaging are our preferred method of maintaining important, relevant and reasonable contact with you. Candy & Chrome are legally required to store information provided, and do so under strict GDPR compliant guidelines, which can be found on the website – www.candy-chrome.co.uk, along with our FAQ’S, rules and T&C’s. The contact information supplied will be used to send email notifications, no more than once a week (but usually less). Emails contain an opt-out option with each notification. You may also on occasion be contacted via SMS, Whatsapp or phone call, but usually only in case of urgency. Contact details of ‘Next of kin’ are only used in case of an emergency. We do not send anything via postal mail to your provided address ever, unless specifically requested. Candy & Chrome do not share personal details with any third parties without your consent, ever. Candy & Chrome may send you friend requests via social media, we take your acceptance of this as acceptance of contact or notifications. Candy & Chrome respects your privacy, and aims to keep marketing to an absolute minimum.
Please provide the email address you actively check, use for social media, and would like to receive mail to.
I am age under 18 (But 16 or over) and require parental consent. I give Candy & Chrome consent to contact the parent I have named below
If you are starting a course of lessons, please enter the course start date
Pole dance & Fitness can be very physically strenuous. It is unsuitable for people who suffer from back or neck problems. Some minor ailments such as occasional joint problems or old injuries may be able to be worked around, however it is mandatory that anything of relevance be clearly stated on arrival.
Pole dance & fitness is a fantastic whole body work out, however most people find that it takes a couple of weekd for the body to adapt to supporting weight on parts of the body that ordinarily wouldn’t be weight baring. Therefore post activity aching can occur. Bruising or chafing may also occur, but just like how your feet adapt to a new pair of shoes, your body will become accustomed to it. During and after your session, you will most likely feel uncomfortable or achy. The sessions will be strenuous and place new kinds of discomfort on your body in places but NOTHING you do should cause acute, serious pain. If you experience this, you must safely stop what you are doing and inform your instructor.
If yes, please give details in the medical notes lower down
If yes, please give details in the medical notes lower down
If yes, please give details in the medical notes lower down
Please note – Pregnant ladies and brand new Mums are not permitted to participate
If yes, please give details in the medical notes lower down
If yes, please give details in the medical notes lower down, including medications, dosage & GP advice
Please give details of any medications you may be taking (including dosage), medical conditions that may be affected by exercise, recent surgery details, details of medical conditions, ailments, GP advisories or even just other information you feel we should know about.
Used ONLY in case of an emergency
I know of no physical or medical condition which I, or my doctor feel could be aggravated by my using of the equipment and participating in activities sponsored by Candy & Chrome. I agree to advise Candy & Chrome in writing if any of the above information changes, or if my doctor advises me to stop, reduce or otherwise adjust my exercise regimen. I will advise my instructor immediately if I injure myself in any way during a session. The above information given on this form is, to the best of my knowledge, complete and accurate. I have read, understood and accept the Terms & Conditions, FAQ’s and Rules outlined on the Candy & Chrome website. I understand that the information supplied will be treated with the utmost confidence, and my participation in the activities lead by Candy & Chrome will be undertaken at my own risk. I am satisfied that I have been informed by Candy & Chrome of the potential risks involved, and participate of my own free will.
I understand all moves, routines, teaching techniques demonstrated to me during the session remain property of Candy & Chrome. My participation in a Candy & Chrome session does not give me authorization to replicate any routines or moves learnt in this session to other participants in any context. Photography and video footage taken during the session by any participants remain the property of Candy & Chrome, and unless otherwise stated, I give full authorization for Candy & Chrome to use my face on any footage taken during the session in any publicity or marketing campaigns in the future. I understand that Candy & Chrome give me permission to take photo’s and video’s of myself during class time for personal use and social media, however I also understand that I am strictly not permitted to include anyone else in these images or footage as I do not have the relevent permissions to do so. I also understand that I am not permitted to record full class and course contant and may be asked to leave without refund if I do not respect the rules outlined on the Candy & Chrome website.
I confirm that I have read, understood and accept the T&C’s, FAQ’s and Rules outlined on the website www.candy-chrome.co.uk