Name *
Name
Address *
Address
Phone
Phone
Name and number of person to contact in the event of an emergency
What are your health and fitness goals?
What activities/ exercise are you currently doing?
Have you been cleared to exercise by your LMC? *
Do you have any pelvic pain and/or abdominal separation from pregnancy? if so, please explain.
Do you have any medical conditions that may affect exercise? eg. Asthma, diabetes, arthritis, carpal tunnel etc.
Do you have any injuries (past or present)? eg. lower back pain, joint pain, surgeries etc.
(Just to give me an idea)
I agree to all the terms & conditions set out on the Class Info Page
(See the terms & conds link at the bottom of the Group Fitt Class page)