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QUESTIONNAIRE

Please take the time to fill in this questionnaire with all relevant and current information about the state of your health and, or any medical conditions.
This information will be stored and used only in line with
the Data Protection Act 1998.

Disclaimer and liability:


A-Core Pole Fitness Centre takes all precautions to ensure the safety of everyone involved. I acknowledge that pole fitness can be strenuous and at times, dangerous. I will rely upon my own judgement in participating in any exercise or manoeuvres. I have been told about the potential risks to my health and freely accept that by participating I run the risk of injury, particularly if I were to fall from, or knock myself on the pole. I understand it is recommended to seek advice from a health care provider before participating, and I agree that I will not hold A-Core Pole Fitness Centre liable for any pre-existing injuries or medical condition, which may be exacerbated if I participate. 

I hereby assume all responsibility for and, on behalf of myself, any heirs, executors, administrators or anyone else who might claim on my behalf, waive all claims against A-Core Pole Fitness Centre and its instructors for, any and all injuries, claims or damages that I might incur. This waiver extends to all claims of any kind what so ever, foreseen or unforeseen, known or unknown, direct, indirect or consequential losses.

Nothing in this waiver shall exclude or limit A-Core Pole Fitness Centre’s liability (i) for personal injury caused by its own or its instructor’s negligence; (ii) for fraud; or (iii) in any way that is not permitted under applicable laws.

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