By submitting this form you agree and understand that any participation in this programme is completely voluntary and you may withdraw from the prescribed exercises at any time. You also confirm that you understand that exercise involves inherent but unlikely risk of injury and in extreme circumstances the possibility of death.
By submitting this form below you confirm that you have answered honestly all of the pre-exercise medical questions and release Keith Molloy from any liability with respect to any damage or injury which you may suffer whilst exercising.
More Than 1 Primary Risk Factor
Individuals with more than 1 primary risk factor should delay becoming more active until they have sought medical clearance from a G.P
More Than 2 Secondary Risk Factors
Those with more than 2 secondary risk factors should also delay becoming more physically active until they have sought medical clearance from a G.P
1. Are you a cigarette smoker or one who has quit within the last 6 months?
5. Do you suffer from diabetes? If so indicate the type & whether you are insulin / glucagon dependent
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