Home Welcome to S&S Fitness’ New Registration Page! Register Below: ← BackYour Registration has been submitted! Please report to reception to complete your registration Personal Details Title Select your title Mr Mrs Miss Ms Dr First Name(required) Surname(required) Address(required) Postcode(required) Date of Birth(required) Mobile(required) Email(required) Doctors Surgery Name Next of Kin Details Name(required) Mobile(required) Health and Safety The health and safety of all our members who exercise in S & S Fitness Ltd is very important to us. For this reason, we wish to establish your current health status before you start your exercise program. The statements below are designed to identify those persons who should obtain advice from our fitness instructors.Do you suffer from:– A heart condition?Do you suffer from breathlessness or chronic asthma?Are you diabetic?Have you ever had chest pain brought on by exercise or at rest lasting more than 60 seconds?Are you aged over 65 and unaccustomed to regular exercise?Do you suffer from epilepsy?Do you suffer from dizziness or loss of consciousness?Are you taking any regularly prescribed drugs or any general medication? i.e. medication for depression etc.Have you ever been diagnosed with osteoporosis or suffered from bone or joint problems?Do you know of any reason why you Should not start using the gym?Do you or have you taken medication for high or low blood pressure or a heart condition?Are you currently pregnant? Yes No If yes, please state which of the above conditions apply. Fire Exits I am aware of all the fire exits, where the first aid is kept and who is responsible Yes No FIRE EXIT PLAN Terms and Conditions TERMS AND CONDITIONS I have read, understood and accepted the terms and conditions of my membership Yes No SUBMITSubmitting form Δ
S&S Fitness Registration