Team 1 Fitness Health and Waiver Form - Team One Kids

Details Participant

Name*

First Last

DOB Participant*

Details Parent/Guardian

Name*

First Last

Mobile*

Email*

How did you find us?*

Referral

Does the participant have any medical conditions, allergies or injuries??*

Yes
No

Please describe

Does the participant take any medication?*

Yes
No

Which medication?

Is there anything else (e.g. health, ability, limitations) you think might be relevant for us to know?

Waiver

MEDICAL STATEMENT

I confirm I have provided all relevant information regarding my child, including details of any medical conditions and any recent medical treatment. I fully understand the nature of the activities my child will be undertaking and I am satisfied that my child is medically fit to take part.

PHOTO CONSENT

I understand that Yves Minten trading as Team One Fitness ("Team One Fitness") may use my child's name, testimonial, image/photograph in publications and advertisements produced by or for Team One Fitness. I understand that these publications will also be placed on web sites and newsletters managed by Team One Fitness for public relations and advertising purposes.

BAD WEATHER

We will make every effort to run activities during wet weather however we reserve the right at our discretion to cancel any session because of unforeseen circumstances, including but not limited to extreme weather. These cancelled sessions will be rescheduled.

RECREATIONAL ACTIVITY WARNING

I acknowledge and agree as follows:

That by participating in any and each of Yves Minten trading as Team One Fitness activities (“Team One Fitness”), my child is undertaking a ‘recreational activity’ within the meaning of the Civil Liability Act 2002 (NSW). I have been warned there may be danger and risk of personal injury or death in the Team One Fitness activities. I accept the risk of injury, death, loss and damage that may occur.
Team One Fitness, it’s employees, directors, officers, instructors, contractors and agents are not liable to you, your dependants or legal representatives in negligence, tort, breach of contract or statutory duty for personal injury, death, loss or damage suffered by you from any Team One Fitness activities.
Team One Fitness excludes liability for breach of any express or implied warranty that the services will be rendered with reasonable care and skill.
Team One Fitness shall incur no liability for consequential or other losses or damage whatsoever by entering into this agreement to the extent permitted by law.

Name of Parent/Guardian Completing the Waiver*

First Last

Today's Date*

By checking this box I agree to have read and agree to the legal agreement above.

0424 245 578

Health and Waiver Form – Team One Kids

Details Participant

Details Parent/Guardian

Waiver

MEDICAL STATEMENT

PHOTO CONSENT

BAD WEATHER

RECREATIONAL ACTIVITY WARNING

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