Fitness Class Liability Waiver

Fitness Class Liability Waiver
Please complete this form to participate in fitness classes and acknowledge the waiver of liability.
Participant Full Name
First NameLast Name
Email Address
example@example.com
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Date of Birth
MonthDayYear
Date
Home Address
Street Address
Street Address Line 2
CityState / ProvincePostal / Zip Code
Emergency Contact Name
Emergency Contact Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Do you have any existing medical conditions or injuries that may affect your participation? If yes, please specify.
Which fitness class(es) are you participating in?
Other
Signature (Please sign below to confirm your agreement to the waiver above)
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Date Signed
MonthDayYear
Date
Additional Comments (optional)
Should be Empty: