You must read and the KGV Recreation Centre membership terms and conditions prior to lodging this form.
Pre-excercise details This is a self-administered and self-evaluated tool to help identify if you may be at higher risk of an adverse event occurring when participating in physical activity / exercise. This tool does not provide advice on a particular matter, nor does it substitute for advice from an appropriately qualified medical professional. No warranty of safety should result from its use. The screening system in no way guarantees against injury or death. No responsibility or liability whatsoever can be accepted by KGV Fitness Centre for any loss, damage or injury that may arise from any person acting on any statement or information contained in this tool.
You answered 'Yes' to one or more questions, please contact KGV for a medical clearance form for your GP or an appropriate allied health professional to sign off on before you can exercise at KGV Recreation Centre. If a future change in your health, medical or physical capacity would lead you to respond 'Yes' to any of the above questions you will be required to re submit this form with a medical/exercise clearance from your GP or allied health professional in order to undertake further physical activity at the KGV Recreation Centre. It is also recommended that clients who have not been physically active and/or are aged 60 years and over consult a medical professional prior to participating in fitness activities
I have read the terms and conditions and understood, agree with and acknowledge the warning, exclusion of liability and release of indemnity and I assume with full knowledge the dangers in my participation in fitness activities and do so at my own risk.
Privacy protection noticePurpose of collection: This information is being collected to assist King George V Recreation Centre to provide appropriate services to you
Intended recipients: City of Sydney employees are the intended recipients.
Supply: The supply of this information voluntary. If you are unwilling to provide this information, the City of Sydney may be unable to provide access to City of Sydney services.
Access/Correction: Please contact Customer Service on 02 9265 9333 or at email@example.com to access or correct your personal information.
Storage: The City Spaces at the City of Sydney, located at 456 Kent Street, Sydney NSW 2000, is collecting this information and the City of Sydney will store it securely.
For further details on how the City of Sydney manages personal information, please refer to our Privacy Management Plan.