Waiver

Are you currently exercising? 

Yes

No

Have you ever had OR do you have:

**PLEASE NOTE: If you have ticked any of the above OR you are NOT SURE – We recommend that you see a doctor prior to beginning an exercise program** Disclaimer:

Stroke

Diabetes

Epilepsy

Heart murmur/condition

Dizziness

Chest pain

Fainting

Palpitations

High blood pressure

Low blood pressure

I agree that I have answered the health questions above to the best of my knowledge and recognize that the instructor is not able to provide me with medical advice with regards to any medical conditions and that this information is used as a guideline to the limitations of my ability to exercise.

Yes

No

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Name *

First Name

Last Name

How did you hear about us?

Word of mouth

Facebook

Internet search

Signage

Referral

Entry is at my own risk in respect of loss, damage or injury to you and your property, however caused, to the in intent that by entering these premises you indemnify and release McRae Fitness and its agents, employees, servants, invites and contractors from any responsibility for loss and/or damage to you or your property bought on to the premises by you.

I declare that to the best of my knowledge the information I have given is correct and that I know of no reason why I should not take part in a strenuous exercise programme.

I will notify McRae Fitness immediately if any of the above details change.

I realise that due to the technical nature of the equipment, and the risk of injury, I must only use equipment I have received instruction on or am familiar with.

During open training sessions, I must take responsibility for my own safety and that of others.

I understand that McRae Fitness cannot accept liability for any accident or injury to myself or others at the centre.

I give consent to my Son/Daughter to training at McRae Fitness (Club) and acknowledge to have read the terms and conditions

Yes

No