Fitness Registration Form

Emergency Contact Number

Reason to Start Exercise (Please tick is/are applicable)

Training Type

Personal Group Group size

Training Period

One month Three months Six months

Training Place

Home/ Clubhouse Public Gym Public Park

Occupation

Job Business Professional

Have you done exercise before?

Yes No

Please specify if any Medical history/problem

Mode of Payment

Cheque DD Bank Transfer

I further understand that any exercise program has the potential to be hazardous and may cause injury. I do, herby, waive and release and forever excuse the personal trainer/coach from any and all responsibilities or liability from injuries, damages or loss. I hereby agree to the terms above and accept any and all risks of injury. I also grant permission to my trainer/coach of Rock - Fitness & Adventure to administer first aid to me and if needed, to call an ambulance, if need be, in the case of any injury. I fully understand that thorough and honest responses to the terms above are essential for my own safety and well-being.

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