top of page

CORE CLASS SCHEDULE

Dec 11 - Dec 17

Good Health Waiver

To take part in sessions please fill out the following medical form

First Name

Email Address

Last Name

Date of Birth

Have you been told by a Doctor not to participate in exercise?

Yes

Do you experience chest pain when exercising?

Yes

Are you or could you be pregnant?

Yes

Have you lost your consciousness in the last past 12 months?

Yes

Do you have any injuries you have not made us aware of?

Yes

Do you know any other reason why you should not take part in physical exercise?

Yes

Initials

Today's Date

I declare that the info I’ve provided is accurate & complete

Thanks for submitting!

Remember:

Before taking part in an exercise program you should always consult a Doctor to ensure it is safe for you to do so.

bottom of page