Pregnancy Disclaimer Form

You must fill this form in before attending any class whilst pregnant.

Name *
Name
Residential Address *
Residential Address
Date of birth *
Date of birth
Any blood pressure problems *
You now need to agree to the client disclaimer below before participating in our classes. Please read through and put a tick in the box provided. *
I confirm that I have completed the above questionnaire to the best of my ability and that I have provided accurate information regarding my current health status. I take it upon myself to discuss any changes in my health with the instructor, my Doctor and/or Midwife. I understand that any exercise program has certain risks. I understand that the degrees of risk depend on my health and physical fitness. I understand that I participate in all classes entirely at my own risk, and any loss, damage, injury or any other mishap will not be the responsibility of the class organiser or teacher.