Team Tieu

Questionnaire

If you answered YES to one or more of the MEDICAL QUESTIONNAIRE questions, please see below.
Talk with your doctor BEFORE you start becoming much more physically active or BEFORE you undergo a fitness programme. Tell your doctor about the GYMBOX Questionnaire and to which questions you answered YES.
• You may be able to do any activity you want- as long as you start slowly and build up gradually. • Or, you may need to restrict your activities to those which are safe for you. • Talk with your doctor about the kinds of activities you wish to participate in and follow his/her advice. • See reverse if you decide not to consult your doctor. • If you answered NO honestly to all the questions
You can be reasonably sure that you can:
• Start becoming much more physically active - begin slowly and build up gradually. This is the safest and easiest way to go. • We recommend you have a group orientation or Personal Training session to determine your basics fitness.
Delay becoming much more active:
• If you are feeling unwell because of a temporary illness such as a cold or fever - wait until you feel better. • If you are or may be pregnant - talk to your doctor before you start becoming more active.
Please note: If your health changes so that you then answer YES to any of the above questions, before exercising tell your Personal Trainer. Ask whether you should change your physical activity plan.

WAIVER CLAIM

Although this questionnaire is designed to assist GYMBOX when advising on individual exercise needs, members are reminded that GYMBOX cannot be held responsible for the health of individual members and that it is the responsibility of all members to consult their doctor prior to commencing any exercise programme.
If you answered YES to any of the questions above, please read and sign below.
GYMBOX strongly advise all Members and Guests to take expert medical advice prior to commencing any exercise programme, if they are in any doubt about their ability to engage in active or passive exercise. I understand GYMBOX staff are not medically trained and are therefore not qualified to assess whether any person is in good physical condition and/or that he/she can engage in active or passive exercise without detriment to his/her health, safety, comfort or physical condition. I have declared on the GYMBOX questionnaire that I have a health problem, however, I do not wish to obtain a doctors referral letter. I wish to attend the club to undertake an exercise programme, and/or use the sauna, and I agree that GYMBOX will not be liable for any injury or health condition I sustain whilst using its facilities arising from any health condition that I have.
Disclaimer for Sparring Classes
I hereby confirm that I am over 18 years of age and of sound mind and that, to my knowledge, I have no conditions (medical, physical or otherwise) which prevent me from participating in contact sport. I have not been advised by any qualified medical or other health practitioner not to participate in activities of a physical contact nature and am not aware of, nor have been advised of any condition, latent or otherwise, which might in any way be aggravated by participation in GYMBOX Sparring classes. I have been advised by GYMBOX to take medical advice before participating in GYMBOX Sparring Classes and have either done so and am aware of the results and the risks inherent in my participation or have decided of my own volition not to take such advice. I understand that as a condition to participating in GYMBOX's Sparring, I will be required to comply fully with the terms of the GYMBOX Guidelines to Sparring as amended from time to time and confirm I have read and fully understood the current form GYMBOX Guidelines to Sparring. I agree to comply strictly with those Guidelines as amended from time to time whenever participating in GYMBOX Sparring and have signed a copy of the Guidelines to evidence my agreement to be bound by and strictly follow their terms. I understand and acknowledge that GYMBOX sparring involves a certain degree of physical contact with other sparring partners, and that while GYMBOX will take all reasonable steps to minimise the risk of injury to those participating, given the nature of the activity such risk cannot be removed completely. In other words, even having taken all reasonable measures, GYMBOX cannot guarantee participants' safety. I acknowledge therefore, that I am participating in GYMBOX's Sparring entirely at my own risk and agree to hold GYMBOX, its agents, employees and affiliated companies ("GYMBOX Parties") harmless in relation to any injury whatsoever I may suffer in the course of GYMBOX Sparring which is not caused by the negligence of GYMBOX parties and to waive all rights, at law and otherwise, I may otherwise be entitled to against GYMBOX Parties in relation to loss, damage, injury or whatsoever nature suffered by me or my property as a result of my participation in GYMBOX Sparring which is not caused by the negligence of GYMBOX Parties. I confirm that I have been advised by GYMBOX staff that, to the extent that I am unsure as to the meaning of any of the above provisions, I should take medical and legal advice before participating in GYMBOX Sparring and by entering my signature below I confirm my full understanding of the above provisions.
If you change your mind at a later date, check out our Privacy Policy on our website at www.gymbox.com for details on how to update your preferences.
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