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AERIAL SPORT & FITNESS DISCLAIMER
First name
Last name
Email
Date of Birth
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required
Contact number
Emergency Contact Number
Emergency Contact
Please specify anything we should know about
Do you have doctor’s permission to participate in intense physical activities?
*
No
Yes
Are you happy for pictures to be used on social media?
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No
Yes
I declare that the info I’ve provided is accurate & complete
Do you agree to the
Terms and Conditions?
Do you agree to and sign the
Disclaimer?
I hereby acknowledge this release from liability for accidental injury or illness which I may incur as a result of participating in any physical activity. I hereby assume all risks connected therewith and consent to participate in this program. I agree to disclose my physical limitations, disabilities, ailments, or impairments which may affect my ability to participate in this program.
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