"I agree to participate in one or more physical fitness program(s)/class(es) provided by Will Power Training Facility. Will Power Training Facility made me fully aware that the fitness programs/classes which Will Power Training Facility offers and in which I desire to participate are of a nature and kind that are extremely strenuous and can/may push me to the limits of my physical abilities. I the undersigned recognise and understand that the programs/classes are not without varying degrees of risk which may include, but are not limited to the following: Injury to the musculoskeletal and/or cardio respiratory systems which can result in serious injury or death, injury or 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, or injury or death due to a medical condition, whether known or unknown by me. I am aware that any of these above mentioned risks may result in serious injury or death to myself and or my partner(s).
I willingly assume full responsibility for any and all risks that I am exposing myself to as a result of my participation in Will Power Training Facility programs/ classes and accept full responsibility for any injury or death that may result from participation in any activity, class or physical fitness program. I herby certify that I know of no medical problems that would increase my risk of illness and injury as a result of participation in a fitness program designed by Will Power Training Facility. Will Power Training Facility informed me that there exists the possibility of adverse physical changes during an exercise program and I fully understand the same. Will Power Training Facility 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, and I fully understand the same. With my full understanding of the above information, I agree to assume any and all risk associated with my participation in Will Power Training Facility fitness programs/ classes.
RELEASE: 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 Will Power Training Facility, and with my full understanding of all of the above, I hereby waive, release, remise and discharge Will Power Training Facility and its agents, officers, principals and employees and volunteers, of any and all liability, claims, demands, actions or rights of action, or damages of any kind related to, arising from, or in any way connected with, my participation in Will Power Training Facility fitness programs/classes, including those allegedly attributed to the negligent acts or omissions of the above mentioned parties.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 remainder 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 Will Power Training Facility to administer first aid deemed necessary, and in case of serious illness or injury, I 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.
Indemnification: I recognise that there is risk involved in the types of activities offered by Will Power Training Facility. Therefore I accept financial responsibility for any injury that I or the participant may cause either to him/herself or to any other participant due to his/her negligence. Should the above mentioned parties, or anyone acting on their behalf, be required to incur legal fees and costs to enforce this agreement, I agree to reimburse them for such fees and costs. I further agree to indemnify and hold harmless Will Power Training Facility, their principals, agents, 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 Will Power Training Facility. .
Indemnification: I recognise that there is risk involved in the types of activities offered by Will Power Training Facility. Therefore I accept financial responsibility for any injury that I or the participant may cause either to him/herself or to any other participant due to his/her negligence. Should the above mentioned parties, or anyone acting on their behalf, be required to incur legal fees and costs to enforce this agreement, I agree to reimburse them for such fees and costs. I further agree to indemnify and hold harmless Will Power Training Facility, their principals, agents, 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 Will Power Training Facility.
Use of picture(s)/film/likeness: I agree to allow Will Power Training Facility, its agents, officers, principals, employees and volunteers the picture(s), film and/or likeness of me for advertising purposes. In the event I choose not to allow the use of the same for said purpose, I agree that I must inform Will Power Training Facility[intial]Cancelling membershipsMonthly paying Members need to give 28 days notice to cancel their membership. If the notice takes them into their next billing cycle, we will pro rata the final payment. Notice can be given, in writing, or by email to ??@???.co.uk Exceptions to this are for injury or illness. We may ask for a letter from a medical professional to confirm this.
I have fully read and fully understand the foregoing assumption of risk, and release of liability and I understand that by signing 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"

Full Name

Date of Birth

Email Address

Contact Number

Emergency Contact Name & Phone

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

Do you feel pain in your chest during physical activity?

In the past month, have you experienced chest pain when not doing physical

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

Do you have any bone or joint problems (e.g. back, knee, hip) that could be made worse by exercise?

Has a doctor ever prescribed medication for your blood pressure or heart condition?

Has a doctor ever prescribed medication for your blood pressure or heart condition?

Do you have diabetes or any metabolic condition?

Are you currently pregnant or have you given birth in the last 6 months?

Do you have any other medical condition that may affect your ability to exercise?

Are you currently carrying any injuries? If yes, please explain.

Have you had any surgeries in the past 12 months? If yes, please explain.

Are you currently taking any medication? If yes, please provide details.

How would you describe your current activity level?

How many times per week do you currently exercise?

What type of training have you done before?

I confirm that the information provided is accurate and complete to the best of my knowledge.

I agree to inform Will Power Training Facility Ltd of any changes to my health status.