Pre-Questionnaire

Please fill in the following questions before coming to your first session. 

Name *
Name
1. Has your doctor ever told you that you have a heart condition or have you ever suffered a stroke? *
2. Do you ever experience unexplained pains in your chest at rest or during physical activity/exercise? *
3. Do you ever feel faint or have spells of dizziness during physical activity/exercise that causes you to lose balance? *
4. Have you had an asthma attack requiring immediate medical attention at any time over the last 12 months? *
5. If you have diabetes (type I or type II) have you had trouble controlling your blood glucose in the last 3 months? *
6. Do you have any diagnosed muscle, bone or joint problems that you have been told could be made worse by participating in physical activity/exercise? *
7. Do you have any other medical condition(s) that may make it dangerous for you to participate in physical activity/exercise? IF YOU ANSWERED ‘YES’ to any of the 7 questions, please seek guidance from your GP or appropriate allied health professional prior to undertaking physical activity/exercise *
WAIVER *
WAIVER I here by certify and agree that I have decided to participate in sessions and activities conducted by Bodybybrando (BBB) with full knowledge and understanding of the risks associated with the strenuous physical exercise that the training sessions involve. I understand that I am in the best position to make my own assessment of my physical condition and to determine whether or not I should participate in the training sessions or any particular activity undertaken as part of the BBB sessions. I agree that BBB (which in this clause includes any servant, agent or contractor of BBB has no duty to warn me of such risks as they are obvious risks. I warrant that I am physically and mentally sound to proceed with the program of exercises and that if any particular activity is beyond my capabilities or may put me at risk I am solely responsible for my decision whether or not to participate in the activity. I agree that BBB will not be liable to me or any other person for whom I am responsible, and I hereby release BBB, in respect of any liability arising out of or connected with loss of or any damage to personal property, or the loss of life or personal injury to, me or any other person, whether that loss, damage or personal injury is caused by the negligence, breach of contract or any other breach of duty by BBB or otherwise. If I am signing this waiver as a Parent/Guardian/Guarantor these agreements and warranties apply as if I am giving them on behalf of my child/infant and I agree to indemnify BBB any liability it may have to my child/infant.