(Exercise at Own Risk)
- Participant (Client) Identification
Full Name: ______________________________________________________
Date of Birth: ______________
Residential Address: ______________________________________________________________ - Declaration of Health Status
I, the undersigned, hereby solemnly declare that:
- My current state of health allows me to undergo physically demanding exercise and sports activities.
- I do not suffer from any serious illnesses (e.g., heart defects, high blood pressure, epilepsy, acute musculoskeletal
injuries) that could be a source of threat to my life or health as a result of exercise. - In the event that I have suffered a serious illness or injury in the past, I have consulted my participation in the exercise
with my attending physician, who has approved the activity. - Women: I declare that I am not pregnant. Otherwise, I shall inform the instructor of my condition, and all risks
associated with exercise and other activities are undertaken exclusively at my own responsibility and risk.
- Agreement to Terms and Liability
- At Own Risk: I acknowledge that I perform all sports activities exclusively at my own risk and own responsibility.
- Risks: I am aware that exercise carries a risk of injury. The instructor/operator bears no responsibility for any harm to
health or property resulting from normal operations or incorrect execution of exercises by the client. - Instructor’s Instructions: I pledge to fully respect the instructor’s instructions. In case of any uncertainty regarding
exercise technique, I pledge to immediately ask for an explanation. - Obligation to Inform: Should any health problems (nausea, pain, dizziness) occur during the exercise, I am obliged to
immediately inform the instructor and cease the activity. - Damages: I am liable for all damages caused by my actions to the equipment of the premises or to other participants.
- Vaccination: In the case of a stay abroad, I have duly familiarized myself with information regarding recommended
vaccinations. Should I choose not to undergo these vaccinations, I am fully responsible for any contraction of such
diseases.
- Personal Data Protection (GDPR)
I consent to the processing of the above personal data for the purpose of client records and further explicitly consent to
the processing of data concerning my health status, as stated in this declaration, for the purpose of ensuring my safety
and health protection, in accordance with the GDPR and the Privacy Policy published at www. __. Health
data will not be provided to third parties.
In _______________ on _______________
Client Signature: ______________________________
(Signature of legal guardian for minors)