Activities (Gym) - Stockton Surf Life Saving Club

Full name

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Have you undertaken an exercise program before?

Are you pregnant?

Please list any current or historical medical conditions e.g. asthma, diabetes, back problems, epilepsy, heart conditions, respiratory illness, broken bones etc.

Do you have any further information relating to any medical condition outlined in question 3, or your exercise history that may be important?

Please list any current medications

Do you agree to the Terms & Conditions for Stockton SSLSC gm?

Terms & Conditions for the use of Stockton SLSC Gym

The information I have provided is true to the best of my knowledge. I understand that I should seek a doctor’s advice if I have a medical condition that may affect my exercise program. I understand that I may require a doctor’s clearance before continuing with using the gym. I agree to inform Stockton SLSC if any changes to my medical condition.
I waive all claims or causes of action which I might otherwise have arising out of loss or life or injury, damage or any other loss, which I may suffer in the course of or consequent upon my entry or participation in any activities in the gymnasium .
This waiver, release and discharge shall operate separately in favour of any person involved in the ownership and/or operation of the Gymnasium. The waiver shall operate whether or not the loss, injury or damage is attributable to the act or neglect of any one or more of such persons.
I acknowledge that I will comply with any reasonable direction of the officials and staff of the Club in relation to:
- (a) entry and exit to and from the Gymnasium
- (b) the use of the facilities and equipment in the Gymnasium;
- (c) my behaviour and conduct whilst on the premises
I acknowledge that I have sole responsibility for my personal possessions and athletic equipment whilst at the Gymnasium or during its related activities.
I consent to receive medical treatment which may be deemed advisable in the event of injury, accident and/or illness whilst on the premises. It is suggested that all persons seek medical advice and obtain a medical clearance prior to engaging in physical exercise.
I am aware that the use of the Gymnasium and its facilities may involve strenuous activity that can be physically demanding and that exercise and the equipment used is potentially dangerous.
I agree that I am in a good state of health and I am medically fit to use the gymnasium facilities and there is no medical reason to prevent me from proceeding with the use of the gymnasium facilities without endangering my health.
I agree to conduct myself in an orderly and proper manner and not emerge in conduct, which could cause harm, create a hazard or nuisance to other members will observe safe practices relating to Covid-19 safety.
I acknowledge that the club cannot warrant the safety and suitability of the Gymnasium equipment.
I hereby assume all risks associated with the use of the use of the premises and facilities.
I have undertaken an orientation tour and induction of the Gymnasium.