PRE-ACTIVITY READINESS QUESTIONNAIRE

Please check if you are experiencing or have in the past experienced any of the following medical conditions: *

Dizziness

Fainting

Stroke

Diabetes

Arthritis

Epilepsy

Glandular fever

Heart attack

Asthma

Chronic fatigue

Panic attacks

Kidney ailments

Heart condition

Low blood pressure

High blood pressure

Infectious disease

MS

Circulation problems

Chest pains

Bone disorder

Blood clots

Heart murmur

Mental illness

Inflammation

None of the above

Prime Athletica strongly recommends that before you undertake any instructed activity, that you should first undergo a wide-ranging and complete physical examination from a registered medical practitioner, to ensure that you are fit and able to commence your exercise program. You should advise your medical practitioner, that the exercise program includes weight lifting, circuit training, aerobic and anaerobic exercise over prolonged periods of time. *

I understand the above

PRIVACY STATEMENT AND ACKNOWLEDGEMENT *

You acknowledge that in completing this form, you will disclose to us information about you that is accurate and true to the best of your knowledge, including information relating to your health. We agree to handle this information with care, professionalism and in accordance with the Privacy Act 1988. By checking the below box, I acknowledge that engaging in physical activity may lead to serious or disabling injuries, even death. I understand that all activities in any exercise program are optional and I may stop at any time. I release PRIME ATHLETICA, its employees and its sub-contractors from all liability for any injury, which I may suffer whilst participating in any activities howsoever caused at Prime Athletica. I assume with full knowledge the dangers of participation in any fitness activities and do so at my own risk. I acknowledge that there are surveillance cameras in all common areas of Prime Athletica, including the reception, the gym floor and in the studio space on the first-floor. I acknowledge that I have read and understood all of the terms and conditions of this agreement prior to signing the agreement and that the information I have given is complete and true to the best of my knowledge.

I have read and acknowledge the above

PERSONAL TRAINING CANCELLATION POLICY *

Please take the time to read this cancellation policy for PRIME ATHLETICA thoroughly as it is strictly adhered to at all times. If you are unsure or have any questions regarding the following, please do not hesitate to contact your personal trainer to discuss the matter further. PRIME ATHLETICA requires a minimum of 12 hours notice for cancellation of a session. Failure to do so will result in the client forfeiting their paid session. Emergency and special circumstances will be considered on a per case basis and while every effort will be made to make-up these sessions, PRIME ATHLETICA holds no obligation to do so. However, this policy works both ways. If your personal trainer is unable to notify you 12 hours prior to a session of their intention to reschedule or cancel, the client is entitled to an additional, complimentary session.

I have read and acknowledge the above