Target Fitness - Registration Form

What are you interested in?

Name

First NameLast Name

Program Cost

Email

example@example.com

Phone Number

Area CodePhone Number

Sex

Date of Birth

Date

Do you have any existing medical/health issues? Please explain.

Emergency Contact (Full Name, Relationship & Telephone #)

How did you hear about Target Fitness?

WAIVER

I am voluntarily participating in the personal or group exercise/fitness programs conducted by Target Fitness. I recognize that the program requires physical exertion that may be strenuous at times and may cause physical injury and I am fully aware of the risks and hazards involved.

I understand that it is my responsibility to consult with a physician prior to and regarding my participation in all aspects of physical activity. I represent and warrant that I have no medical condition that would prevent my participating in any training sessions conducted by Target Fitness.

I willingly assume full responsibility for the risks that I am exposing myself to and accept full responsibility for any adverse result from participation in any activity or class while at, or under the direction of Target Fitness.

You agree and consent to the above waiver statement:

Signature

Today's date

Date