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Health and Liability Waiver

To register to our programs or private training please fill out the following medical form

Completing this form is an an agreement that you have read our liability and terms

First Name

Email Address

Last Name

Date of Birth

Do you have a doctor’s permit to participate in intense physical activities?

No

Yes

Have you lost your consciousness in the last past 12 months?

No

Yes

I declare that I have read and agree to the Liability Waiver and that the info I’ve provided is accurate & complete

Initials

Today's Date

Thanks for submitting!