HEALTH BACKGROUND SCREENING

Please carefully read the below questions. If the answer to any of the following questions is YES, please provide details in the box below. 

Do you suffer from a heart condition or have ever had any form of heart disease, previously suffered a heart attack, or have a family history of heart disease?

Do you experience any pain while undertaking physical activity or exercising?

Have you ever experienced faintness, dizziness, shortness of breath, or experienced a loss of balance while undertaking physical activity or exercise?

Do you have diabetes or suffer from high blood pressure? Do you suffer from asthma?

Do you have a bone or joint problem that could be aggravated by a change in your level of physical activity?

Do you have any other medical condition or injury, currently taking medication, or know of any other reason that would prevent you from exercising?

 

ADDITIONAL DISCLOSURES AND WAIVER

Boss Battle Martial Arts and Fitness is a Gym that engages in strenuous and high intensity exercise routines based upon combat sports. You should consider whether this style of exercise is suitable for

By signing this form, you acknowledge and fully understand the risks involved in participating in this form of exercise. You also understand that these mentioned acts can potentially cause injury. In the unlikely event that you get injured, by signing this form you release Boss Battle Martial Arts, it's organizers, promoters, instructors, and participants from any and all liabilities now or in the future including but not limited to; medical, hospital, paramedic or ambulatory care.

  

By signing this form, I/we authorise Boss Battle Gym and its direct debit provider, Pay Advantage, to debit the nominated bank account for the membership payments, fees, and charges set out in this agreement, in line with the agreed amount, frequency, and start date. I/we confirm that I/we are the account holder or an authorised signatory to the account, understand that both signatures are required for joint accounts, and acknowledge that the Direct Debit Terms and Conditions have been provided and accepted as part of this authority. I/we also understand that if a debit is dishonoured or declined, a dishonour fee of $6.82 may be charged.

Members Name and Signature *Guardian if under 18 years of age.

WELCOME TO THE BOSS BATTLE FAMILY!