Boxing bootcamp, a fun way to lose weight, tone up, and improve your fitness :: located in Geelong, our fun and exciting program lets you work at your own pace :: Geelong boxing bootcamp!

Pre-assessment Questionnaire

You're nearly there!  Just one last thing.

If you're new to Geelong Boxing Bootcamp, we'd like you to spend a few minutes filling in the form below - this will allow us to make sure that bootcamp is suitable for you.

If you've been involved in a Bootcamp within the past two years, and there's been no significant changes to your health, you needn't fill in the form.

Name
Address
Suburb
Postcode
Mobile (or other)
Email
Date of Birth
Emergeny Name
Emergency Contact No
   
T-Shirt Size

 

Please list any medications you are currently taking
Do you have diabetes?
Do you have epilepsy?
Have you had a stroke?
Have you had a heart attack or other heart condition?
Do you suffer from asthma?
Have you recently had surgery?
Are you pregnant?
Do you often feel faint or have spells of severe dizziness?
Has a doctor ever said you have high blood pressure?
Do you suffer any bone / joint / muscle problems?
Do you suffer amy back problems?
Do you have any current or past injuries that may affect your ability to exercise? If so, please describe the injuries, along with details of how they occurred
If there is any other KNOWN physical reason that prevents you from participating in an exercise program, please provide details
   
Declaration: I hereby represent to Fit N Focused, its management and employees that I am physically capable of and there are no medical reasons to prevent me from proceeding with the use of the studio/gym premises and any external activities conducted by Fit N Focused without endangering my health. I acknowledge that whilst on and off studio/gym premises (outdoor sessions); my person, my guests, my property, and my guest property are at my own risk. I acknowledge that I will not hold Fit N Focused and/or its trainers responsible for, to the extent permitted by law, all liability for any personal injury or damage (whether direct, indirect, special or consequential). I acknowledge that except as provided in this document Fit N Focused gives no warranties in respect of the facilities and equipment it provides. I hereby release and will indemnified Fit N Focused and its trainers for any injury or loss suffered by me whilst on the studio/gym premises or engaged in training sessions conducted externally.