Fitness Registration Fitness Sign Up Form Please enable JavaScript in your browser to complete this form.Email *Name *FirstLastDate of Birth dd/mm/yyyyPhone *Address *GenderMaleFemaleHow tall are you?What is your weight?What do you do for a living?Do you smoke?YesNoCasuallyWhat are your fitness goals?Do you exercise regularly? *I have never exercised regularlyI used to exercise regularlyI currently exercise regularlyRate your ability to perform cardio exercises *Very lowFairAverageGoodExcellentRate your experience with exercise *BeginnerIntermediateAdvancedDo you have any injuries or have you been hospitalised? Is there anything that you need to mention regarding your current health status?Medical Conditions / Allergies / Learning Difficulties - Please list any conditions you / or your child including skin allergies, diabetes or epilepsy.Emergency Contact Name *RelationshipEmergency Telephone Number *Requested lesson time and start date (depending on availability)I am signing up for;In person personal training or group fitnessOnline personal training or Zoom sessionsWhat fitness and wellness activities are you interested in?BoxingWeight LiftingPlyometricsHIITWater AerobicsSwimmingRunningJump RopeYogaCrossFitMeditationPlease add any extra comments here;How did you hear about Jennuine Fitness?Google searchFacebookThrough a friendBy signing up with Jennuine Fitness activities, I acknowledge that I will receive an email from time to time to keep me in the loop about products and services *Yes, I acknowledge, thanks!I hereby agree to the following; That I am participating in the training, programs, exercises and events, Jennuine Fitness Classes ordered by Jennifer Bexley, or alternative instructor during which I receIve instruction. I understand that it is my responsibility to consult with a physician prior to and regarding my participation in any Fitness Program. I represent and warrant that I am physically fit and I have no medical condition that would prevent my full participation in this class. In consideration of being permitted to participate in any Group Fitness Class or Personal Training, I agree to assume any responsibility for any risks, injuries or damages, known or unknown, which I might incur as a result of participating in the program. In consideration of being permitted to participate in any Fitness Program I knowingly, voluntarily, and expressly waive any claim that I may have against Jennifer Bexley, owners, landlords and insurers or any Jennuine Fitness Instructor for injury or damages that I may sustain as a result of participating in the program. I, my heirs or legal representatives forever release, waive, discharge, and covenant not to sue Jennifer Bexley, owners, landlords or any Jennuine Fitness Instructor any injury or death caused by their negligence or other acts. I have read the above release and waiver of liability and fully understand its contents. I voluntarily agree to the terms and conditions above. *Yes, I agreeSubmit
