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Forge Fitness UK Ltd - PAR Q

Please answer the following questions honestly and If you answered Yes to any of the above, please consult with your doctor before becoming more physically active or undergoing a fitness assessment.

Has your doctor ever said you have a heart condition and that you should only do physical activity recommended by a doctor?

Yes

Do you feel pain in your chest when you do physical activity?

Yes

In the past month, have you had chest pain when you were not doing physical activity?

Yes

Do you lose your balance because of dizziness or do you ever lose consciousness?

Yes

Do you have a bone or joint problem (e.g. back, knee, or hip) that could be made worse by a change in your physical activity?

Yes

s your doctor currently prescribing medication for your blood pressure or a heart condition?

Yes

Do you know of any other reason why you should not do physical activity?

Yes

Declaration I confirm that the information provided above is accurate to the best of my knowledge. I understand that I am responsible for monitoring my own condition during exercise and will inform gym staff of any changes to my health. In addition I acknowledge that participation in physical activity involves inherent risks, including but not limited to injury, heart attack, or even death. I voluntarily assume all such risks. By signing below, I hereby release and discharge Forge Functional Fitness, its staff, coaches, and affiliates from any and all liability, claims, demands, or causes of action arising out of or related to my participation in gym activities, except in cases of proven negligence.