Postnatal Fitness Waiver Form
Please complete this form to acknowledge and accept the terms of participation in postnatal fitness activities.
Full Name
*
First Name
Last Name
Email Address
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Date of Birth
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
How many weeks postpartum are you?
*
Have you received clearance from your healthcare provider to participate in postnatal fitness activities?
*
Yes
No
Please list any relevant physical limitations or concerns (if none, leave blank). Do not include sensitive health details.
Signature
*
Date
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Submit Waiver
Submit Waiver
Should be Empty: