DAY PASS Valid for one dayCan be purchased in advancePlease fill out the form. Name * First Name Last Name Phone * (###) ### #### Email * How did you hear about us? Live locally/saw signs Word of mouth Instagram Other social media Google/website Do you have a heart condition, high blood pressure or other circulatory problems? * No Yes Do you have diabetes? * No Yes Do you ever experience pain in your chest when exercising or at rest? * No Yes Do you ever feel faint or suffer from dizzy spells? * No Yes Do you have back pain or joint conditions that could be exacerbated by exercise? * No Yes Do you have asthma? * No Yes Have you had any surgery in the past year that may affect your physical activity? * No Yes Are you aware of any other condition or injury that may give reason to modify your exercise programme? * No Yes Are you taking any medication? * No Yes Are you pregnant? Or have you given birth in the past six weeks? * No Yes Please select date * MM DD YYYY Thank you!
