NLF covid19 ParQ | Next Level Fitness

NLF COVID19 PAR-Q

To partake in any of our scheduled group fitness classes or programmes, please ensure you fill out this form to the best of your knowledge and agree to the waiver below.

First Name

Last Name

Date of Birth

Have you or any member of your family tested positive for COVID19 in the last 6 weeks?

Yes

If answered yes above, do you confirm you have adequatly self-isolated and have adhered to government guidelines?

Yes

Not applicable

Today's Date

Next Level Fitness has put in place preventative measures to reduce the spread of COVID-19; however, we cannot guarantee that you will not become infected with COVID-19. Further, attending NLF could increase your risk of contracting COVID-19. By signing this agreement, I acknowledge the contagious nature of COVID-19 and voluntarily assume the risk that I may be exposed to or infected by COVID-19 by attending NLF and that such exposure or infection may result in personal injury, illness, permanent disability, and death. I understand that the risk of becoming exposed to or infected by COVID-19 at NLF may result from the actions, omissions, or negligence of myself and others, including, but not limited to, NLF employees, volunteers, owners, coaches and gym participants and their families. I voluntarily agree to assume all of the foregoing risks and accept sole responsibility for any injury to myself (including, but not limited to, personal injury, disability, and death), illness, damage, loss, claim, liability, or expense, of any kind, that I may experience or incur in connection with my attendance at the NLF or participation in NLF programming (“Claims”). On my behalf, I hereby release, covenant not to sue, discharge, and hold harmless NLF, its employees, agents, and representatives, of and from the Claims, including all liabilities, claims, actions, damages, costs or expenses of any kind arising out of or relating thereto. I understand and agree that this release includes any Claims based on the actions, omissions, or negligence of NLF, its employees, agents, and representatives, whether a COVID-19 infection occurs before, during, or after participation in any NLF class or program.

I agree to the above waiver

Your Signature

Unit 10, Woolsey Shopping Complex,

Moy Road,

Portadown

NEXT LEVEL FITNESS

be more

NLF COVID19 PAR-Q

NORTHERN IRELAND'S HIGHLY COMMENDED SMALL STUDIO GYM 2019

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