Polestar Pilates Australia
Continuing Education Registrations
Send registration forms to: Polestar Pilates Australia - 26 Roseberry Street, Balgowlah NSW 2093 - Ph: 02 9091 9400 - Fax: 02 9977 1546
(EARLY BIRD IS FOR REGISTRATIONS RECEIVED 60 DAYS PRIOR TO COURSE START DATE)
Standard Price
Early Bird
PAA Member
PAA Early Bird
1 Day Course
$300
$270
$290
$260
2 Day Course
$600
$540
$580
$520
Advanced Assessment Skills 1
$900
$800
Advanced Assessment Skills 2
$600
$580
CONTACT INFORMATION:
First Name:
Last Name:
Email:
Address:
City:
Sate:
Mobile:
PCode:
Home Phn:
CREDENTIALS: Please tell us about your qualifications and Pilates Experience
Pilates Year of Certification:
Completed Pilates Training with:
Current Profession:
Any health conditions or injuries that may
prevent you training to full potential?
COURSE REGISTRATION: I WISH TO REGISTER FOR THE FOLLOWING CONTINUING EDUCATION COURSES
Course Name
Location (city being held)
If using the PAA member pricing, please list your membership nos here:
Date
Cost
TOTAL:
PAYMENT OPTIONS:
Cheque / Money Order:
Please make cheques payable to: Polestar Pilates Australia
Direct Deposit:
Polestar Pilates Australia - BSB: 112879 - Account no. 066964451 - type your name as reference
CREDIT CARD SURCHARGE: Visa/Mastercard 1.5%. This fee will be added to your invoice
Credit Card Type:
Visa:
Y/N
Card Number:
Mastercard:
Y/N
Expiry Date:
Verify code: (Last 3 digits on
back of card or 4 digits on AMEX)
I give authorization for Polestar Pilates Australia to deduct the above stated course fee from my credit card and surcharges as applicable.
Name on Card:
Signature:
REGISTRATION POLICY & APPLICANT AUTHORITY
 I understand that I will attend the Polestar course, use the facilities and equipment at my own risk. I can confirm that I have disclosed
all medical conditions and injuries, both past and present and have obtained clearance from my general practitioner with regards to such
conditions. I will take it upon myself to discuss any changes to my current health with my instructor. I recognise that the instructor is not
able to provide me with medical advice with regard to my medical fitness and that the information provided is used as a guideline to the
limitations of my ability to exercise.
 Course fees include workshops, manuals, and certificate of completion at end of workshop.
 Registration requires payment in full, deadline is 14 days in advance of start date. Registration received less than 14 days will be
processed only if space is available otherwise, you will be contacted. You are not registered until payment is received
 Cancellations accepted for refund minus $25 non-refundable portion, with written notice post-marked 14 days prior to start date. No
refunds issued for notice less than 14 days prior.
 We reserve the right to postpone or cancel any course. If we cancel a course, you will have the option of transferring to another course,
receiving a credit valid for 1 year or receiving a full refund.
By signing this application I agree that all information supplied is true. I agree to the terms and conditions outlined above.
Signature:
Polestar Pilates Australia - 26 Roseberry Street, Balgowlah NSW 2093
E: info@polestarpilates.com.au www.polestarpilates.com.au
Date:
P: +61 2 9091 9400 F: +61 2 9977.1546
Polestar® is a registered trademark of Polestar Education LLC