Note that Term 4 commences on 7 October 2021.

This screening tool does not provide advice on a particular matter, nor does it substitute for advice from an appropriately qualified medical professional. No warranty of safety should result from its use. The screening system in no way guarantees against injury or death. No responsibility or liability whatsoever can be accepted by Exercise and Sports Science Australia, Fitness Australia or Sports Medicine Australia for any loss, damage or injury that may arise from any person acting on any statement or information contained in this tool.

AIM: the following questions are used to identify individuals with a known medical condition, or signs or symptoms of a medical condition, who may be at a risk of an adverse event during physical exercise. It does not provide advice on a particular matter, nor does it substitute for advice from an appropriately qualified medical professional. No responsibility whatsoever can be accepted by Exercise and Sports Science Australia, Fitness Australia, Sports Medicine Australia or Kangatraining Australia for any loss, damage or injury that may arise from any person acting on any statement or information contained in this tool.

you MUST obtain written medical clearance from your GP or allied health professional prior to exercise

and you have no other concerns about your health, you may proceed to undertake light-moderate intensity physical activity/exercise

I believe that to the best of my knowledge, all of the information I have supplied within this tool is correct.

I hereby understand and acknowledge that the training, programs and activities provided by KANGATRAINING may expose me and/or my child to inherent risks including, but not limited to, accidents, injury, illness and death. I assume all risk of injuries associated with the participation including, but not limited to, falls, contact with other participants, use or hire of baby carriers, the effects of weather, including high heat and/or humidity, and all other such risks being known and appreciated by me. I hereby acknowledge my responsibility in communicating any physical and psychological concerns that might conflict with my own, or my child's, participation in the activity. I acknowledge that I am physically fit and mentally capable of performing the physical activity I choose to participate in. I confirm that if I am pregnant I have received written consent from my doctor that I am able to participate in my chosen activity. I confirm that where I have hired the Insured's baby carrier, that my child does not exceed the manufacturer's recommended weight of 20kg. After having read this waiver and knowing these facts, and in consideration of acceptance of my participation and KANGATRAINING furnishing services to me, I agree, for myself and anyone entitled to act on my behalf to indemnify and keep indemnified, KANGATRAINING, its servants and licensee, and each of the, against all actions, costs, claims, charges, expenses, penalties, demands and damages whatsoever which may be brought or made by me or on my behalf. I undertake to indemnify and hold harmless and free, KANGATRAINING and its licensees, from any and all claims of whatsoever nature or cause (including negligence) and however arising, which may be made by myself or anyone else on my behalf who suffer the damages (including but not limited to damages arising from or related to personal injury, death and/or loss of support) of whatsoever nature. I agree to comply with all the rules, regulations and instructions in relation to the chosen activity. I have read and understood the content and important consequences of this document and acknowledge that I am bound thereby.

To compete your class registration, payment is required before the class commences (unless otherwise arranged with your instructor). I accept bank transfer or cash. My bank details are: Account Name: Amy Gron BSB: 484 799 Account Number: 610 613 380 Reference: YOUR FULL NAME