top of page
Gym Health Waiver
To register to our gym please fill out the following medical form
First Name
Email Address
Last Name
Date of Birth
Do you have a doctor’s permit to participate in intense physical activities?
*
No
Yes
Have you lost your consciousness in the last past 12 months?
*
No
Yes
Initials
Today's Date
I declare that the info I’ve provided is accurate & complete
Submit
Thanks for submitting!
bottom of page