Health Declaration

Please fill out the following health declaration form in order to participate in the booked activity and let us know if any of the information below changes so that we can update our records.
Do you have any pre-existing medical contitions that might affect your health during class?
If taking a fitness or well-being class, On a scale of 1-10 (10 being the most active) how active is your lifestyle currently?

Release, Waiver(and Guardian Consent if under 18 years old)

 

I am aware of the physical injury risks involved with exercise and understand that it is my responsibility to consult with my physician prior to my participation in any classes or prior to receiving any instruction. In consideration of the acceptance of my registration for the activities and programs offered by Studio at 39, I hereby for myself, my heirs, executors, administrators, or any others who may claim on my behalf, promise not to sue, and hereby waive, release and discharge Studio at 39 and anyone acting for or on its behalf, from any and all claims of liability for personal injury, illness, loss of life or property damage of any kind or nature, arising out of or sustained in the course of my participation in the activities and programs offered or sponsored by Studio at 39 or by attending Studio at 39 related events in any location. This Release and Waiver applies to all claims, foreseen or unforeseen, including negligence and breach of statutory or other duty of care (including that owed under The Occupier’s Liability Act).I agree that Studio at 39 is not responsible in the event of loss, damage, unauthorised use, theft, or injury resulting from and to any personal property that I bring to classes held in any location. I have read this document carefully and acknowledge that I have complete knowledge and understanding of its contents. I recognise that by signing this document I am waiving certain legal rights, including the right to sue.

Thanks for submitting!