Please answer all questions to the best of you knowledge.
If you have any health concerns that are not listed in this form, please contact a member of the HG3 Fitness staff before attending a fitness class.
Do you have any allergies or allergies to any medication?
Do you suffer from high or low blood pressure or postural hypertension?
Has your doctor ever said that you may have a bone or joint problem that has or could be made worse with exercise?
Have you suffered from any head trauma, concussion in the last 6 months?
Do you suffer from any metabolic diseases such as Diabetes Mellitus?
Have you ever been diagnosed with raised cholesterol?
Do you ever feel faint or have spells of severe dizziness
Is there any history of Coronary Heart Disease in your family?
Do you drink more than the recommended units of alcohol per week (male 21 units/female 16 units) ?
Are you pregnant or have you recently had a baby?
Have you suffered from any major illness or had any major surgery in the past two years?
Do you suffer from epilepsy or seizures?
Do you know of any reason that you should not partake in physical exercise?
Are you currently suffering with any of the 3 covid-19 symptoms?
Have you been in contact with anyone with Covid-19 symptoms or positive test result?
I agree to participate in a physical fitness program sponsored by HG3, which may include , but not necessarily be limited to, training. HG3 has made me fully aware that the fitness program which HG3 offers, and in which I desire to participate, is of a nature and kind that is extremely strenuous and may push me to the limits of my physical abilities. I recognise and understand that the programme is not without varying degrees of risk which may include, but are not limited to the following:
Injury to the musculoskeletal and/or cardio respiratory system which can result in serious injury or death.
Injury to death due to negligence on the part of myself, my training partner, or other people around me.
Injury or death due to improper use or failure of equipment.
Injury or death due to a medical condition, whether known or unknown to me.
I willingly assume full responsibility for any and all risk that I am exposing myself to as a result of my participation in HG3’ programme, and accept full responsibility for any death that may result from participation in any activity or physical programme. I herby certify that I know of no medical problems that could increase my risk of illness and injury as a result of participation in a fitness programme designed by HG3. HG3 informed me that there exists the possibility of adverse physical change during an exercise programme and I fully understand the same. HG3 informed me that these changes could include abnormal blood pressure, fainting, disorder of heart rhythm, stroke, and in very rare instances, heart attack or even death. With my full understanding of the above information I agree to assume and and all risk associated with my participation in HG3s’ fitness programme.
Release of Liability
In full consideration of the above mentioned risks and hazards and in full consideration of the fact that I am willingly and voluntarily participating in the activities made available by HG3, i hereby waive, release and discharge HG3 and its employees and volunteers of any kind related to, arising from, or in any way connected with my participation in HG3s’ fitness programme.
This agreement shall be binding upon me, my successors, representatives, heirs, executors, assigns, or transferees. If any portion of this agreement is held invalid, I agree that the reminder of the agreement shall remain in full legal force and effect. If I am signing on behalf of a minor child, I also give full permission for any person connected with HG3 to administer first aid deemed necessary, and in case of serious illness or injury give permission to call for medical and or surgical care for the child and to transport the child to a medical facility deemed necessary for the well being of the child.
I recognise that there is risk involved in the types of activities offered by HG3. Therefore I accept financial responsibility for any injury that I may cause either to myself or to any other participants due to my negligence. I further agree to indemnify and hold harmless HG3, their employees and volunteers from liability for the injury or death of any person(s) and damage to property that may result from my negligent or intentional act or omission while participating in activities offered by HG3.
I agree to allow HG3, its employees and volunteers to use picture(s), film and/or likeness of me for advertising purposes and on its social media sites. In the event I choose not to allow use of such media I must inform HG3 of this writing.
I have fully read and understand the foregoing assumptions of risk and release of liability, and I understand that by signing below it obligates me to indemnify the parties named for any liability for injury or death of any person and damage to property caused by my negligent or intentional act or omission. I understand that by signing this form I am waiving valuable legal rights.
This membership bills every month. Payment for the first partial period will be prorated according to the days remaining in the period. This membership entitles the purchaser to a full or partial discount on events/classes offered by the business. Some classes/events may be excluded from this membership. Unless otherwise noted, this membership is non-transferable. Your payment details will be securely stored in our system for the duration of the membership.
This membership will be billed monthly and will entitle the purchaser to a partial or complete discount on events/classes offered by the business. Some classes/events may be excluded from this membership. Unless otherwise noted, this membership is non-transferable. See the details on the "Description" tab for more information.
Payments will be charged automatically each month on the 1st (first) of the month. The initial payment will be prorated for a partial month, as necessary, calculated as (number of days remaining in the month)/(monthly fee).
Cancellation of membership payable by direct debit must be in writing or email to the HG3 Fitness - [email protected], providing three full calendar month’s notice e.g. written notice received on or before 31 December will terminate membership on 31 March and written notice received during January will terminate membership on 30th April. On cancellation you remain liable for three calendar month’s subscription during the notice period. Cancelling your direct debit instruction for the monthly fee or a verbal instruction to any member of staff is not sufficient