Копия Sutton Coldfield

Personal Details

Health Screening

Participation Agreement

Membership Terms

Photo Consent

Full Name (Required)

Please enter your full name

Email Address (Required)

Please enter a valid email address

Mobile Number (Required)

Please enter your mobile number

Emergency Contact Name (Required)

Please enter emergency contact name

Emergency Contact Phone Number (Required)

Please enter emergency contact phone number

Preferred Class Location & Day (Required)

Please select your preferred class location and day

This form is not medical advice.
If you answer YES to any question, please ensure you have checked with a GP or healthcare professional before participating.

1. Has a doctor ever said that you have a heart condition or that you should only do physical activity recommended by a doctor?

Yes

Please select an option

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

Yes

Please select an option

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

Yes

Please select an option

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

Yes

Please select an option

5. Do you have a bone or joint problem that could be made worse by a change in your physical activity?

Yes

Please select an option

6. Is your doctor currently prescribing medication for blood pressure or a heart condition?

Yes

Please select an option

7. Are you currently pregnant, recently post-natal, or returning to exercise after pregnancy?

Yes

Please select an option

8. Is there any other reason why you feel you should not take part in physical activity?

Yes

Please select an option

(Required – checkboxes)

I confirm that the information I have provided is accurate and complete.

I understand that participation in classes is at my own risk.

I agree to follow instructor guidance and modify movements where needed.

I understand that if I feel unwell, dizzy, or uncomfortable, I should stop immediately and inform the instructor.

(Required – checkboxes)

I understand that memberships secure my place in class rather than individual attendance.

I understand that missed classes are not refundable or transferable.

I understand that flexibility options are priced accordingly.

Please select one:

Yes, I consent to photos/videos being used for marketing purposes

No, please do not include me in photos/videos

Complete Your Payment

Please select your payment option to confirm your registration:

Your place is confirmed once payment has been received.

Копия Sutton Coldfield

Adult Class Registration & Health Screening

Complete Your Payment

Новый ресурс

Копия Sutton Coldfield

Adult Class Registration & Health Screening

Complete Your Payment

Новый ресурс

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