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Registration Form 2020

Client Lookup

Have you already enquired with us?

Personal Details

Emergency Contact Information

Medical Information

Your safety while exercising is our priority, therefore it is important to us that, in preparation for your physical activity, you tell us ALL about your existing medical and physical conditions. It is your responsibility to complete this form before participating in any physical activity. For any conditions that can be affected by exercise, you may be asked to consult your doctor and obtain a written medical clearance to exercise. The information contained in this clearance will be treated as confidential and only revealed to the relevant staff/instructors for your safety. If the answer to any of the below questions is YES, please specify the details in full. In such a case you may need to obtain written consent from your doctor before commencing training with us or receiving advice from us.

Physical Activity Readiness Questionnaire Plus:

Please read through the questions carefully and answer each one honestly yes or no

Please provide details:

Other Health Questions:

Please read through the questions carefully and answer each one honestly

Personal exercise goals

I have read and understood the above registration form. I understand that in the event that I do not follow the instructions provided to me by the Fitness Instructor or Silver Fit that Silver Fit has the right to terminate the relationship and to request that I no longer participate in the exercise classes.

Consent for Silver Fit Classes During the COVID-19 Pandemic

Attendance Agreement:
I, the Member, hereby agree:
Knowingly and willingly, to attend elective exercise group classes, by the company Silver Fit, during the COVID-19 pandemic. That I understand the COVID-19 virus has a long incubation period, during which carriers of the virus may not show symptoms and still be highly contagious. That it is still recommended, where possible and practical, that sessions are attended online.
That I am not presenting any symptoms of COVID-19.
That I understand that high risk patients, relating to the severity of COVID-19, are persons over the age of 60, and persons who have pre-existing medical conditions such as; asthma, chronic lung conditions, hypertension, autoimmune diseases, organ transplants, cancer, immunocompromised, obesity (BMI over 40), liver or kidney conditions.

That I am aware of the risks involved with the spread of COVID-19 and the risks it may hold to my health and the health of others I come into contact with. I accept those risks and hereby indemnify Silver Fit and its instructors blameless should I contract the disease at a class.

Practical Guidelines for the Class:
I agree to the following:
Members will only be admitted if they have pre-booked themselves in to a specific class.
Members will complete the screening form electronically before attending any classes, failing to complete, or failing the screening means they will not be allowed to attend the class.
Members will be stopped from entering the site if they haven't adhered to the proper control measures.
Members will arrive ready for class with only what is needed for that class. They will bring their own theraband, mat, water bottle and towel. Silver Fit will provide chairs.
All members will be sprayed with hand sanitiser upon entry.
All members must wear a face mask at all times.

November 26, 2020