AquaVibe Application Form
Please read the 'AquaVibe Terms and Conditions' at the bottom before submitting this form.
Your full name
Not confident swimmer
Do you have any fears of being in the water?
2.Emergency contact details
Do you have any current or pre-existing medical conditions or symptome?
If 'YES', please advise full medical details in the next question
Please provide details of your medical conditions
E.g. Medication, diabetes, asthma, allergies, arthritis, osteoporosis, back pain, heart attack, lung disease, etc…
Have you ever had any injuries or surgery?
If 'YES' please provide details in the next question
Please provide details
Do you have any other medical conditions relevant to your participation with AquaVibe?
Personal information approval
I confirm that all information are true
4.Booking and Payment
Class numbers are limited and bookings are ESSENTIAL to save disappointment.
1.Enrolment Form MUST be completed PRIOR to your first class.
2.Payment MUST be made PRIOR to any class participation.
⇒ Please ensure you have completed all these conditions in order to attempt a class, otherwise you will be refused for insurance and safety purposes.
10 AquaVibe Passes option MUST be paid for in ONE transaction only.
Passes can be used for any Aqua class and are valid for 6 months.
Payment can be made by:
DIRECT DEPOSIT – AquaVibe account details will be provided upon class confirmation. Please ensure you include your name as a reference when making the deposit.
*Please arrive early to allow time to do so.
*Please have the correct money, as no change will be available.
Choose an AquaVibe class
Lesson classes are subject to availability
What class/es are you going to attend?
Saturday 09.30am Mirage Country Club
Option 2 TBA
Choose a location
Mirage Country Club or QT
Own swimming pool
Invoices will be emailed to you upon confirmation of classes.
Casual - $15/class
5.Cancellation & Refunds
If you have booked a class and your are enable to attend it please provide a full 24 hours notice.
No refunds, credits or alternative class will be made for missed classes without notice.
In the event of illness, when full payment has been made, one catch up voucher will be issued per participant.
The catch up voucher is available for 6 months and subject to availability.
It is not transferrable or redeemable for cash refund.
Where a withdrawal from class is requested a credit or refund will be issued from the date of a medical certificate is presented.
Classes will still operate if it's raining. However in the event of torrential heavy rain/thunders storm or lightning, classes will be cancelled by text and an alternative class will be offer as a catch up.
7.Visitors or non-participants
Family members are allowed on the poolside, but all children MUST be supervised by an adult at ALL time.
8.Informed Consent / Waiver of Liability
You understand that AquaVibe exercise program contains strenuous physical activity including, but not limited to, aerobic exercise, conditioning or resistance training, deep and shallow-water exercise, interval and circuit training, stretching for flexibility, and the use of various exercise equipment owned by AquaVibe.
You hereby affirm that you are in good physical condition and do not suffer from any disability which would prevent or limit your participation in this exercise program.
We strongly advise you take expert advice prior to commencing any aqua class if you are in any doubt about your ability to engage in this program and you will tell your aqua instructor before participating in any class.
You shall not participate in AquaVibe class whilst suffering from any infections or contagious illness, disease or other physical ailment such as open cuts or sores where there is a risk, however small, to other members or guests.
During class, you agree to limit you activity to a level that is comfortable to you and stop all activity if you feel uncomfortable. You will notify the class instructor and your physician if the class causes any discomfort to yourself. You understand that all forms of exercise involve some risk of injury.
In consideration of your participation in the AquaVibe program, entitling you to engage in water fitness activities, you hereby release and discharge, now or in the future, AquaVibe, its employees, owners and subcontractors from any liability to you, actions, suits, proceedings claims, demands, losses, damages, penalties, fines, costs and expenses, injuries, however arising from your participation in this program.
You assume full responsibility for, and risk of, bodily injury, death or property damage due to the negligence or fault of Releasees or otherwise.
==> You certify that your participation in AquaVibe classes is solely at your own risk and you take full responsibility for your own health and well being before, during and after classes.
You affirm that you are exercising with your physician’s approval regarding this program and you fully understand the above agreement.
AquaVibe Terms and Conditions Final Agreement
By clicking the ‘Submit’ button, you fully understand and agree to the AquaVibe Terms and Conditions above.
Other comment or enquiries
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