Waiver Waiver Title (required) ---MrsMsMissMrDrOther First Name (required) Surname (required) Your Email (required) Contact Number (required) Emergency Contact (optional) Date of Birth (required) House name/number (required) Address Line 1 (optional) City (required) Postcode (required) What are your fitness goals? (optional) Disclaimer Please read the following clauses and accept them at the bottom to begin your fitness journey! Health Warning You should review the exercise and product instructions before beginning a Power Plate exercise program. Power Plate machines have been used successfully worldwide, but should you have a medical condition, it is strongly recommended that you seek medical advice before using a Power Plate machine. If at any time you feel faint, dizzy, short of breath or any pain then stop using the machine immediately and consult a GP. By signing this form, you confirm you know all of the contraindications to the Power Plate and/or Laser Lipo, and have informed the instructor of any medical condition. Informed Consent Power Plate sessions will consist of activities that are designed to gradually improve the efficiency with which the body functions. Exercise levels will be regulated by trainer. During the session, and for a period after, you may experience local muscular soreness and fatigue. These minor discomforts should disappear within 72 hours. All personal information acquired during the sessions will be treated as confidential. You are free to stop the session at any time. Please make sure that before signing this form, all your questions have been answered. Take as much time as necessary to think it over if you wish, discuss your participation with your doctor. By signing you recognise that your instructor is not able to provide you with medical advice with regards to existing conditions and acknowledge that you should consult your GP and update this form if your medical status changes. Do you accept these terms?