Medical Declaration Form

ARMOUR ACADEMY

Member Medical Questionnaire & Waiver Form

Please complete in full for either yourself or your child/children and give to your instructor to check before beginning any training with us. Please inform the Instructor of any reasons or medical conditions which may not allow you or your child/children to participate in any type of physical activity safely.

Full name of person joining & personal information:

    Address

    Member Information - Health Questionnaire (Section 1)

    Common sense is your best guide when you answer this questionnaire. Please read the questions carefully and answer each one:

    *Has your doctor ever said that you have a heart condition and that you should only do physical activity recommended by a doctor?

    *Do you feel pain in your chest when you do physical activity?

    *In the past month, have you had chest pain when not doing physical activity?

    *Do you lose balance because of dizziness or do you ever lose consciousness?

    *Do you have bone or joint problems (for example, back, knee, or hip) that could be worsened by a change in your physical activity?

    *Is your doctor currently prescribing any medication (for example: water pills) for your blood pressure or heart condition?

    *If the answer to the above is yes, please provide further information below:

    *Do you know of any other reason why you should not do physical activity?

    *Do you have any skin conditions? – if yes, please specify

    *Have you had any surgery? – if yes, please specify

    *Do you require consent from a UK medical practitioner (GP) before you are allowed to participate in any of our classes?

    If the answer is “Yes” to the above question, please inform your instructor immediately and DO NOT begin any training until authorised by the Head Instructor or Management at Armour Academy

    *Have you had the COVID-19 virus?

    *Please provide the date that you tested positive: Date/Month/Year

    *Have you been vaccinated against Covid-19?

    *Have you/person training had a high temperature in the last 24 Hours?

    I HAVE READ, UNDERSTOOD AND COMPLETED THIS QUESTIONNAIRE FACTUALLY.
    ANY QUESTIONS I HAD WERE ANSWERED TO MY FULL SATISFACTION.



    If you submit this form by email from your email address this will be accepted as a form of
    signature and you do not have to sign the form here

    Member information & Liability waiver

    If you have answered ‘NO’ to all questions in Section 1 you can be reasonably sure, but at your own risk, that you can be physically active. If you answered ‘YES’ to one or more questions you should consult with your doctor before embarking on any physical exercise. We take your health and safety seriously and we wish to highlight that physical activity and training can lead to risk of injury and even death in exceptional circumstances. I agree that ARMOUR ACADEMY is not responsible or liable for any health related, injuries or damages resulting from you or your child’s/children participation in any activities or classes. I agree to train and attend classes or enrol my child/children at my/their own risk and understand the dangers associated with the type of physical activity and classes we offer with the potential for serious personal injury and potential loss. I agree that I will comply with all health and safety protocols and that I or my child/children will train safely. I certify that I or my child/children are physically fit, have no pre-existing medical conditions that would affect me partaking in any of the classes at ARMOUR ACADEMY or general physical activity and have completed the health questionnaire factually. I also certify that I will inform ARMOUR ACADEMY if my health or the health of my child/children changes. The answers provided above are accurate and truthful to the best of my knowledge and I do not believe that there are any reasons I should not take part in the physical activities involved at ARMOUR ACADEMY.

    I grant permission to ARMOUR ACADEMY staff only to take photos and videos and I grant the rights of my image in video or in still or of those individuals registered as members by myself. I understand that it may be edited or copied to use as part of promotional advertising on various social media and advertising platforms.

    I wish to be kept informed and to be contacted by Armour Academy (GDPR)

    (For persons under 18 years of age this form must be signed by a parent or legal guardian)


    If you submit this form by email from your email address this will be accepted as a form of
    signature and you do not have to sign the form here