Climbing Yoga Sheffield Medical Disclaimer and Terms and Conditions

Please do not knowingly omit any information as this may affect your health and safety during physical exercise. Should Dan feel his services may not meet your needs, there will be no charge, and Dan will signpost you towards an appropriate healthcare professional.

Name

First NameLast Name

Email

Phone Number

Area CodePhone Number

Emergency Contact/Next of Kin

First NameLast Name

Emergency Contact Telephone Number

Area CodePhone Number

Are there any reasonable adjustments Dan can make to facilitate your participation in the session? E.g. To help you manage any mental or physical health conditions, to help you access the venue, to ensure you are comfortable during the session.

YesNo

If you have answered yes to the above question, please provide details below:

To help inform your session and maintain your health and safety, please detail any past or current, physical injuries, medical conditions or health concerns.*

Are you happy for video's to be taken to aid in your session and provide you with a mobility resource (if applicable) for your reference afterwards? [Once you have confirmed receipt of your mobility resource, any videos will be permanently deleted]

Yes I am happy for video's to be takenNo please do not take videos

Dan asks for upfront payment via bank transfer to secure your booking.
You can re-arrange a session, free of charge, provided you contact Dan more than 48 hours in advance. There is a £20.00 charge to rearrange, if you fail to contact Dan more the 48 hours in advance.
If you do not attend your session, no refund can be provided.

As with all physical exercise the risk of injury is always present and cannot be completely reduced. Dan assess's and minimizes the level of risk for all exercises and sessions. To partake in the session you must TICK EACH OF THE 6 BOXS TO AGREE with the following points:

Exercises should not be painful! Please ensure you inform Dan of any pain or discomfort you feel during the session, and any exercises can be modified accordingly.There may be a level of discomfort which can be intelligently worked through. The most appropriate way to do this can be ascertained at the time by open discussion between yourself and Dan.It is your responsibility to inform Dan of any changes to your health or contact details that may occur after submitting this form.If you have any questions, before, during or after the session do not hesitate to ask Dan directly.In attending your session you agree to assume the inherent level of risk involved in physical exercise, and take full responsibility for your health and safety during the session.Your mobility training plan (if applicable), will only include exercises that Dan assessed as working well for you during the session. After the session, it is your responsibility to discontinue any exercise and contact Dan for direct advice should you start to experience pain or discomfort within or after the exercise.

Typed Signature: A typed signature followed by the addition of 2 initials and the word 'signature' constitutes a signed agreement. E.G Chris Jelly (CJ-Signature). [If you are a parent or guardian completing this from on behalf of someone under the age of 18 please sign your own name.]*

e.g. Chris Jellye.g (CJ-Signature)

Climbing Yoga Sheffield Medical Disclaimer and Terms and Conditions

During any coaching session with Climbing Yoga Sheffield you assume full responsibility for your health and safety. You also must continue to abide by the venues own terms, conditions and policies. You must have signed into the climbing center and paid your entry fee as per usual.

As a Registered Occupational Therapist Dan is trained in mental and physical health and can tailor sessions to meet your individual needs.

Payment and Cancellations

Making the most of your session