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Movement | Stretch Class Consent Form
Please read the Terms & Conditions below before completing your consent form.
Terms & Conditions
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Date of Birth
Mobile Phone Number
Please list any current & past medical conditions | injuries | operations
Please list any significant mental health issues past or current
Are you pregnant or have had a baby in the last 6 weeks?
Are you taking any prescribed medication and if so what is it for?
Have you ever been told that you have arthritic joints/any bone or joint problem that would be made worse by exercise? If so please detail.
Do you currently have any current injuries or restrictions with your movement?
In case of emergency who should I contact? (please list name, relationship & phone number)
I agree to the terms and conditions listed for the Stretch Class presented by Marika Cominos
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Based in Melbourne, Australia
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