AF CHIPPENDALE GREEN CLASS BOOKING
Thursday 12:15pm
Name
First Name
Last Name
Email
example@example.com
Phone Number
Gender
Male
Female
Date of Birth
-
Month
-
Day
Year
Date
Back
Next
Class Booking
Please choose 1 or multiple dates
Appointment
Back
Next
Back
Next
I understand there are inherent risks in all aspects of physical training and I acknowledge the possible strenuous nature of the training and the potential for undesirable physiological results. I understand that the training may involve weightlifting, gymnastic movements, strenuous bodyweight exercises, boxing and other high exertion activities, and that I am not obligated to perform nor participate in any activity that I do not wish to do, and that it is my right to refuse such participation at any time during my training sessions.
YES
I understand that should I feel lightheaded, faint, dizzy, nauseated, or experience pain or discomfort, I am to stop the activity and inform my trainer. I give AF Chippendale permission to administer first aid deemed necessary, and seek medical services for me should I become injured or ill with the understanding that I am responsible for any expenses incurred. If I am signing on behalf of a child, I give the same permission.
YES
All high-intensity exercise must be approached cautiously in the beginning, to allow muscles cells to adapt to the new demands being placed on them. Failure to do so can lead to a serious condition known as ‘Rhabdomyolysis’, where the muscle cells are damaged flooding the bloodstream with toxins. It is important that you start ANY new exercise at a reduced intensity. Brown urine, complete muscle weakness and/or swelling of joints are warning signs. If you develop any of these symptoms, see your doctor immediately.
YES
I agree to WAIVE ANY AND ALL CLAIMS that I have or may have in the future against AF Chippendale directors, employees, and independent contractors. I agree to release these parties from any and all liability for any loss, damage, injury or expense that I may suffer, or that my next of kin may suffer as a result of my participation in the programs, activities and services provided by AF Chippendale and its trainers due to any cause whatsoever including negligence, breach of contract, or breach of any statutory or other duty of care. I agree to HOLD HARMLESS AND INDEMNIFY the aforementioned parties of any and all liability for any damage to the property of, or personal injury to, any third party, resulting from my participation in any program, activity or service provided by the parties.
YES
I agree to allow AF Chippendale to use picture(s), film and/or likeness of me for advertising purposes. In the event I choose not to allow the use of the same for said purpose, I agree that I must inform AF Chippendale of this in writing.
YES
I have read and understood this agreement and am aware that by signing this INFORMED CONSENT FORM that I am waiving certain legal rights which I or my next of kin, Executor or Administrators may have against the partie
YES
LIABILITY WAIVER
Submit
Should be Empty: