Regular exercise can provide a number of health benefits. However, with physical activity comes an increased chance for sports related injuries. To make sure you are not taking any unnecessary risks, please read the questionnaire and answer all the questions carefully.

By submitting this form you acknowledge that you have answered all of the questions above truthfully and to the best of your knowledge. If you answered YES to any of the above medical questions, it is strongly recommended that you get the permission of your doctor before participating in this activity. R II M Fitness, LLC and all it’s employees/contractors are not responsible for the physical well being of clients taking this class with known health concerns.

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Name
Yes or No
Yes or No
Yes or No?
Yes or No?
Yes or No?