Membership Form

I'm interested in:

Pre Exercise Screening:

Gender *
Are you currently excercising? *
Have you consulted a doctor about starting an exercise program? *
Do you have any current injuries? *
Do you have any allergies? *
Are you currently taking any medication? *
Do you have problems with your back? *
Do you have any neck/shoulder problems? *
Do you ever get dizzy? *
Do you have low blood pressure? *
Do you have diabetes? *
Do you have an infectious disease? *
Are you or could you be pregnant? *
Do you have a liver or kidney condition? *
Do you have or have you had Cancer? *
Do you have Epilepsy? *
Have you done Crossfit before? *
Have you participated in strenuous exercise before? *
Have you ever had any form of heart disease? *
Have you ever experienced shortness of breath or chest pains? *
Do you have a family history of heart disease? *
Do you have problems with your knees? *
Do you have any hip/pelvis problems? *
Do you smoke? *
Do you have high blood pressure? *
Are there any exercises you know you cannot do? *
Is there any reason you know of that you should not participate in exercise? *
Do you have Asthma? *
Do you or have you had Rheumatic or Ross River Fever? *
Do you have Arthritis? *
Do you have or have you had a Thyroid Condition? *
Do you have high cholesterol? *

By clicking on the SUBMIT button, I agree that if I engage in any physical exercise sessions with CROSSFIT HIGHFIELDS, I do so at my own risk. I am fully aware that the fitness programs/sessions which CROSSFIT HIGHFIELDS offer and in which I desire to participate in are of the nature and kind that are extremely strenuous and can/may push me to the limits of my physical abilities. I understand and recognise that the program/sessions are not without varying degrees of risk which may include but not limited to, injury to the musculoskeletal and/or cardio respiratory systems which can result in injury or worst case scenario death. I acknowledge that I have carefully read this disclaimer and fully understand that it is a release of liability and I accept full responsibility for any and all risks that I am exposing myself to as a result of my participation at CROSSFIT HIGHFIELDS. I understand that I am waiving any right that I may have to bring a legal action to assert a claim against CROSSFIT HIGHFIELDS and their trainers.

Acknowledgement *