Waiver | WarriorBelleFitness

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coachkatt@warriorbellefitness.com

Warrior Belle Fitness with Coach Katt

Client Health Waiver

Please fill out the following form
in order to participate in our class.

First Name

Email

Last Name

Date of Birth

Emergency Contact Name and Phone Number (please make sure this person knows you are participating in a coaching program with Warrior Belle Fitness and that they are your emergency contact)

Have you been hospitalized in the last 12 months? *

No

Yes

Are you suffering from a medical condition, illness, or injury? *

No

Yes

If you answered yes to any question, please elaborate

Initials

I declare that the info I’ve provided is accurate & complete and that I have consulted with my health care provider prior to joining this program.

Thanks for submitting!

Still have questions?
Email coachkatt@warriorbellefitness.com.

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