Full Name: Age: Date of Birth: Email:
Full Name: Relationship: Telephone Number:
Have you ever trained at a gym or under a personal trainer?
Where do we come into the plan for you, how can we assist you in reaching your goals?:
**We recommended that you seek a medical clearance from your health professional prior to commencing any exercise program.**
I confirm that I have read through in full this electronic form including the attachments, the Membership Form, and the Membership Terms and Conditions.I confirm that the details and information that I have provided within this Health Questionnaire Form is true and correct.I confirm that I have read and understand the Terms & Conditions.I consent to the electronic signature of this Health Questionnaire Form.
Leave this empty:
Your legal name
Your email address
Signed by Liam Carrick-Ryan
Signed On: January 12, 2022
If you have questions about the contents of this document, you can email the document owner.
Document Name: Health Questionnaire Waiver
Agree & Sign