top of page
Gym & Fitness Liability Waiver
Has a doctor ever said that you have bone or joint problems such as arthritis, that has been aggravated by exercise or made worse with exercise?
Do you have Diabetes Mellitus or any other metabolic disease?
Has your doctor ever said that you have raised cholestrol (above 6.2mmol/l)?
Has your doctor ever said that you have a heart condition and that you should only perform physical activity recommended by your doctor?
Have you ever felt pain in your chest when you do physical activity?
Is your doctor currently prescribing you any drugs or medication?
Have you ever suffered from shortness of breath at rest or with mild exertion?
Is there a history of heart problems in your family?
Do you often feel faint, have spells or severe dizziness or have lost consciousness?
Do you currently drink more than the average amount of alcohol each week (21 units for men and 14 units for women)?
Do you currently smoke?
Do you NOT currently exercise on a regular basis (at least 3 times per week)?
Are you, or is there a possbility that you might be pregnant?
Do you know of any other reason why you should not participate in a programme of physical activity?

Thanks for submitting!

bottom of page