This form is designed to assess whether you need a medical clearance before you commence an exercise program, join a health & fitness facility or aim to increase your current level of physical activity.
Please read each question carefully and answer them to the best of your knowledge.
If you answered YES to any of the above questions we recommend under the guidelines of AUSactive that you consult a GP or health professional prior to undertaking or participating in a fitness activity in our facility.
AN INDUCTION / ORIENTATION IS OFFERED TO ALL PERSONS ABOVE 18YRS
Please sign here if you do not wish to take part in an Induction
AN INDUCTION / ORIENTATION IS MANDATORY FOR ALL PERSONS UNDER 18YRS
I understand I am enrolling in a program of physical activity and use of various conditioning and exercise equipment. I hereby affirm that I am in good physical condition and do not suffer from any medical conditions or have any physical restraints that would prevent or limit my participation in such physical activity. I fully understand that I may suffer injury as a result of my participation and I hereby release the Trainer and The Premises from any and all liability now or in the future, including but not limited to, medical expenses, lost wages, pain and suffering, that may occur by reason of heart attacks, muscle strains, pulls or tears, broken bones, shin splints, heat prostration, knee/lower back/foot injuries, and any other illness, soreness, or injury, however caused, whether occurring during or after my participation in the
program or use of the conditioning and exercise equipment and facilities, regardless of fault.
I hereby agree to accept and be legally bound by this agreement. By signing below, I attest, contract, acknowledge, and agree that I am legally bound in consent.
PARENTAL/GUARDIAN CONSENT FOR PERSONS 16 – 17 YEARS:
I give my consent for my son/daughter or ward whose information is listed, to access the Evolve 24/7 Fitness Weights room & /or Fitness classes. I hereby certify that the above participant is in normal health and capable of safe participation in this fitness program. I assume all risk(s) and hazards incidental to the conduct of this program and for the transportation to & from the facility. I hereby authorise Evolve 24/7 Fitness to obtain medical treatment for the participant listed above in the event that a parent or the emergency contact cannot be reached. I understand that my son/daughter/ward enters into any exercise program using the facilities at his/her own risk & I hereby Evolve 24/7 Fitness for any injury or damages which may arise from his/her participation or any known or unknown medical conditions whilst in Evolve 24/7 Fitness Weights Room &/or Fitness Classes. I understand that my son/daughter/ward will have to or has completed a Personal Induction by a qualified trainer at Evolve 24/7 Fitness to use the Weights Room.
**I understand that a fitness trainer is not always in attendance in the Gym and that it is my responsibility to ensure that my son/daughter/ward has a current exercise program.**
