NuBody Fitness Buddy Pass Form
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Name of Person that Gave you a Buddy Pass:
POLICY AND RELEASE WAIVER
In enrolling at NuBody Fitness Systems, participant understands that he/she attending the programs and using NuBody Fitness Systems and or the facilities does so at his/her own risk. NuBody Fitness Systems and its owners, employees or agents, shall not be liable for any damage whatsoever arising from any personal injury or property loss sustained by participant with his/her family in or about any programs on the premises. Participants and parents assume full responsibility for all injuries and damages which occur in or about any programs on the premises. He/She does hereby fully and forever release discharged hold harmless NuBody Fitness Systems, all associated facilities and its owner, employees, and agents from any and all claims, demands, damages or rights of action, present or future resulting from any person's participation in any programs or use of the facility. In addition, he/she agre to follow the rules of conduct and play set by NuBody Fitess Systems. Failure to do so may result in suspension from participation. Consent: I the undersigned parent or guardian/participant do hereby grant authority to the staff at NuBody Fitness Systems to render a judgment concerning medical assistance or hospital care in the event of an accident or illness during my absence. I do hereby authorize NuBody Fitness Systems and its assigns to utilize any and all media including but not limited to photographs, pictures or other likeness of me or anyone assigned guardianship to me, as they deem appropriate in its promotional materials or films.
BY CLICKING SUBMIT YOU AGREE TO THE PARAGRAPH ABOVE.
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 you were not doing physical activity?
Do you have a bone or joint problem that could be made worse by a change in your physical activity?
Is your doctor currently prescribing drugs (for example, water pills) for your blood pressure or heart condition?
Do you lose your balance because of dizziness or do you ever lose consciousness?
Do you know of any other reason why you should not do physical activity?
Notes
PAR-Q
By Checking this box I am stating that I have read, understood and completed this questionnaire. Any questions I had were answered to my full satisfaction.
Name of Staff who was Witness to this Document being filled out:
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James Simpson
Jazmin Skipper
Lawrence Lovejoy
April-Joi Norman
Jamaal Miller
Kate Marshall