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Health Clearance & Waiver
Minor Health Clearance & Liability Waiver
Is the minor participant medically cleared to participate in exercise?
*
No
Yes
Has the minor participant's doctor ever said that they have a heart condition and that they should only do physical activity recommended by a doctor?
*
No
Yes
Does the minor participant feel pain in their chest when they do physical activity?
*
No
Yes
In the past month, has the minor participant had chest pain while not doing physical activity?
*
No
Yes
Does the minor participant lose their balance because of dizziness or ever lose consciousness?
*
No
Yes
Does the minor participant have a bone or joint problem that could be worsened by a change in their physical activity?
*
No
Yes
Does the minor participant's doctor currently prescribe drugs (for example, water pills) for their blood pressure or heart condition?
*
No
Yes
Do you know of any other reason why the minor participant should not do physical activity?
*
No
Yes
I understand and acknowledge that there is inherent risk with increased physical activity, and I assume responibility for that risk.
I acknowledge that myself and my minor participant are responsible for safely navigating the workout space as is
I declare that the health info I’ve provided is accurate & complete
I will not hold Leaner Fitness or it's owners liable for any injury or health event that may occur during training services or while using the workout space
By checking this box, I represent that I have read, fully understood, and voluntarily agree to be bound by all the terms and conditions of this agreement. I further acknowledge that my electronic signature provided below is intended to have the same legal effect as a handwritten signature and is fully enforceable.
Today's Date
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