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Warriors Health & Contact Form - 2020
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First name *
Your answer
Last Name *
Your answer
Date of Birth (click the year to scroll) *
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DD
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YYYY
Email Address *
Your answer
Phone Number *
Your answer
Full address including postcode *
Your answer
Emergency contact details (full name and phone number) *
Your answer
Has your doctor ever said you have a heart condition or need doctors recommendation to exercise? *
If you answered yes to the above - have you discussed this program with your Doctor (N/A if not applicable) *
Do you ever feel pain in your chest when you do physical activity? *
Have you ever had chest pain when not taking part in physical activity? *
Do you ever feel faint or have spells of dizziness? *
If yes - please describe (please enter N/A if not applicable) *
Your answer
Do you have joint problems that could be made worse from exercising? *
Have you ever been told you have high blood pressure? *
If yes - please describe (please enter N/A if not applicable) *
Your answer
Are you currently taking any medication that the instructors need to be aware of? Please list below or N/A *
Your answer
Are you (or could you be) pregnant? Or have you had had a baby in the last 6 months? *
Is there any other reason why you should not participate in physical activity? *
Your answer
#WARRIORS does not accept any liability or responsibility for any injuries that may occur during any class. You are willingly taking part in our sessions at your own risk. We do not accept any liability for any items or property that is lost or stolen at any of our venues. You agree to being included in group photography and being included in recordings (video and/or audio) during sessions. This material may - at any future date - be posted onto our social media channels (with or without your name). We will use your email address to subscribe you to the notification and news letter section of our website this is to keep you updated on events, sales and emergency information. You understand that it is your responsibility to re-complete this form if your health or medical circumstances change. By clicking "I understand" below, you agree to all of the above. *
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