YOUR DETAILS

Emergency Contact 1

Emergency Contact 2

Medical Information

Consent & Declarations

Do you consent to first aid or treatment deemed necessary by a qualified first aider should an emergency occur?

—Please choose an option—YesNo

Do you agree that your medical information can be discussed between our medical and coaching staff where we believe such information may impact on your ability to partake in the session?

—Please choose an option—YesNo

Participating in any exercise has a risk of injury. Do you accept the risk and will not hold Strive Health Club or its staff responsible for any injury you may sustain during a training session?

—Please choose an option—YesNo

Do you agree with our policy on physical contact?

—Please choose an option—YesNo

Do you consent to being photographed or videoed for the purposes of coaching or promotional material?

—Please choose an option—YesNo

I declare that the information within this form is true. I understand that it is my responsibility to inform Strive Health Club on any changes to this form.

—Please choose an option—YesNo

Code of Conduct Agreement

Please read the following Code of Conduct and agree to the terms below.

—Please choose an option—YesNo

Date