New Customer Registration Form

Full Name*

First NameLast Name

Date of Birth*

Date / Month / Year

Phone Number*

E-mail*

example@example.com

Address*

Street Address

Street Address Line 2

CityState / Province

1. Do you have any health concerns or injuries*

If yes to health concerns or injuries, please describe

2. Do you require G.P. clearance to exercise? *

If yes to G.P clearance to exercise, please describe

3. Are you taking any prescribed Medication / Special Diets that could affect you in any way during exercising?*

If yes to prescribed Medication / Special Diets, please describe

4. How did you hear about our Classes?

5. What is your reason for doing our Classes?

6. How many days per week do you exercise and what type of activity do you do?

6. Studio and Online Classes. By Submitting this Form I understand that:*

My use of these classes is solely at my own risk, whether supervised or unsupervised.The exercises provided by PB Fitness are intended for my own personal use only and links are not to be passed on.As with any fitness class, if at any point I feel faint, dizzy or pain, I should stop immediately and seek medical advice.

I note a constant update is expected and if situations change after completing and submitting this form, I commit to advising PB Fitness and excluding myself, if, at any point in the future I would answer 'Yes' to the above questions at 1 and 2.

The exercises provided by PB Fitness are intended for your own personal use only. You should consult with a Doctor before beginning any exercise or fitness routine, especially if you are pregnant or have pre-existing health conditions or injuries. Your use of these classes is solely at your own risk.

I have read this form in its entirely and hereby certify that to the best of my knowledge I am medically and physically capable of taking part in a prescribed exercise regime. I also agree to discharge and hold harmless PB Fitness from any liability arising from an accident / injury sustained as a result of withholding relevant information which I knew or ought to have known and brought to the attention of PB Fitness.

Client Registration Form

Health