Health questionnaire


For your safety, it is important that we are aware of your current medical and physical status. Please complete this form as fully as possible. All information provided will remain confidential. Please let us know if any of these details change in the future.

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I have answered NO to all the health questions

I am over 16 years old



Informed Consent for Exercise Participation

I would like to take part voluntarily in fitness classes in order to attempt to improve my physical fitness.

I understand that the cardiovascular activities are designed to place an increasing workload on the heart and lungs and to thereby attempt to improve their efficiency. Toning exercises will exert muscles which should improve muscular endurance and flexibility exercises should improve/maintain range of motion.

I understand that I am responsible for monitoring myself throughout the class and, should any unusual symptoms occur, I would cease participation and inform the instructor of the symptoms.

In signing this consent form, I confirm that I have read this form and that I understand the nature of the exercise programme. I also confirm that my questions regarding the exercise programme have been answered to my satisfaction.

In the event of any injuries occurring as a result of attendance, Jazzy B Fitness staff / owner is hereby released from any liability now, or in the future, for conditions that may be obtained from participation.

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