FIT2XL Day Course Booking Enquiry

For more details or any queries please contact Barry or Dezzi on: 01254 245207 or 07834355890 email fit2xl@hotmail.com

Alternatively you can use the contact form below or click to download a printable form.

Personal Details

Name

Date of birth

Address

Post Code

Phone

Occupation

Reason for participating

Medical Questionnaire

FIT2XL requires the individual to complete this medical questionnaire to ensure your safety throughout the course.

Are you now or have you ever suffered from any of the following? Please answer Yes or No.

Heart conditions (heart attack, angina, irregular heartbeat, hole in the heart etc…)	Yes No
High/Low blood pressure	Yes No
Back or joint problems	Yes No
Diabetes	Yes No
Respiratory illness (Asthma, bronchitis, emphysema)	Yes No
Fainting/Dizziness	Yes No
Under medical treatment for any illness	Yes No
Had any serious injury or operation within the last 18 months	Yes No

If you answered ‘Yes’ to any of the above questions we may contact you for more details and strongly advise you not to participate on the course before having taken medical advise.

Please tick here if you do not wish to receive notice of special offers from us

How did you find us

By submiting this form I have read and understood the information above and agree to take full responsibility for my actions whilst on the FIT2XL course

Please note that FIT2XL reserves the right to refuse the individual entry on the course if you do not complete this form fully and to the best of your knowledge. FIT2XL cannot be held liable for any injury that may occur to any person, not caused by the neglect of its employees or by equipment failure.