Team transformers registration form

Name

First Name

Last Name

Date of Birth

YYYY

Mobile number

Email Address

List and current injuries you may have

List any medical conditions you currently have or have had in the last five years and medication you are taking. *

How did you enjoy your first six weeks and do you have any feedback for us :)

What are your goals going forward after your initial 6 weeks ?

I know the location and purpose of the following. (If unsure see images below)

Difibrillator

First aid kit

Fire exits

Fire extinguishers

I understand that hold periods for team transformers are limited to 2 weeks per 3 month term. For example 6 months term = 4 weeks of hold total.

I agree

I confirm that I have completed the above questionnaire to the best of my ability and that I have provided accurate information regarding my current health status. I take it upon myself to discuss and changes in my health with the gym. I understand that any exercise program has certain risks. I understand that the degrees of risk depend on my health and physical fitness. I am voluntarily participating in the fitness program and will immediately discontinue any activity if I feel any symptoms of distress or discomfort and will notify my trainer. I understand that the trainer is not a health or Medical Practioner and therefore cannot diagnose or treat individual health or medical problems. All such concerns should be directed to my own General practitioner and I agree to do so.

First aid Kit and defibrillator are located down the hall way towards the bathroom. Fire extinguisher 2 is also located here.

Fire exit is located at the back left of the gym next to the drinking fountain. Please only use in an emergency as this door is alarmed. Fire extinguisher one is located at the fire exit

Please swipe your card with every visit to our facility. Our swipe reader is located on top of reception as you enter the door.

Team transformers registration form

help@bkt.co.nz

PRIVACY POLICY