Health Questionnaire

If you have not recently done so, consult with your doctor before increasing your physical activity and tell your doctor which questions you answered yes to.

In consideration of being allowed to participate in the activities and programmes by Jill Stuart, in addition to the payment of any fee or charge, I do hereby waive, release and forever discharge Jill Stuart of any and all responsibility or liability for injuries or damages resulting from my participation in any activities or my use of equipment or facilities in the above mentioned activities. I understand and am aware that strength, flexibility and aerobic exercise, including the use of equipment are potentially hazardous activities. I also understand that exercise and fitness involve a risk of injury, and that I am voluntarily participating in these activities and using equipment and facilities with the knowledge of the dangers involved. I herby agree to expressly assume and accept all and any risks of injury or illness. I do hereby declare myself to be physically sound and suffering from no condition, impairment, disease or infirmity or other illness (other than those declared on the overleaf medical questionnaire) that would prevent my participation or use of equipment or facilities except as herein started. I acknowledge that I have either had a physical examination and have been given my doctors permission to participate, or that I have decided to participate in activity and use of equipment with the approval of my doctor and do hereby assume all responsibility for my participation and activities, and utilisation of equipment in my activities.