HEALTH QUESTIONNAIRE

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  • Medical History:

    Are you suffering from any of the following? (Tick all applicable)
  • Disclaimer:

    I have disclosed on this form all relevant health and medical details which may affect my ability to perform exercise. I understand that the instructions given throughout the class are intended only as a guidance and it is my responsibility to adjust my practice according to my needs to ensure that no personal injury to myself occurs. I hereby declare that I take full responsibility for myself while attending classes at Awaba Retreat.