Sisters Fitness Brampton Islamic Center

Sisters Group Fitness
Name*

First NameLast Name
Emergency Contact Name & Number*

NameNumber
Email
example@example.com
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number*
Please enter a valid phone number.
Date of Birth*

MonthDayYear
Date
Which session are you registering for?*
Do you have any health conditions, injuries, or medical issues we should know about?(Please list anything such as asthma, joint pain, recent surgery, etc. If none, write “None.”)*
I understand that participation in fitness activities involves physical exertion. I confirm that I am in good health and have no medical conditions that would prevent safe participation. I take full responsibility for my health and safety during the classes and release the instructor, Brampton Islamic Center, and Saqr Modest Activewear from any liability.
I have read and agree to the above statement.
For Participants Under 18

the parent/guardian of the participant named above, give permission for my child to participate in the fitness classes. I understand that all activities will be conducted in a private, women-only environment, and I acknowledge the terms of the liability waiver above.
Parent/Guardian Name

First NameLast Name
Parent/Guardian Signature

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