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Gym Waiver
First name
Last name
Email
Date of birth
Do you have a doctor’s permit to participate in intense physical activities? (if I have chosen not to obtain a physician’s permission, I hereby agree that I am doing so at my own risk)
*
No
Yes
Please specify anything we should know about
I declare that the info I’ve provided is accurate & complete
I hereby acknowledge this release from liability for accidental injury or illness which I may incur as a result of participating in any physical activity. I hereby assume all risks connected therewith and consent to participate in this program. I agree to disclose my physical limitations, disabilities, ailments, or impairments which may affect my ability to participate in this program.
I agree to the
privacy policy.
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