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Health Waiver

Before you train with us you must ensure that you have complained this health waiver and are well enough to train.

Roots & reps Waiver

To register with Roots & Reps please fill out the following medical form

First name

Email Address

Last name

Date of Birth

Do you have a doctor’s permit to participate in intense physical activities? *

No

Yes

Have you lost your consciousness in the last past 12 months? *

No

Yes

Do you have any existing health conditions? *

No

Yes

If so, what are they?

Initials

Today's Date

I declare that the info I’ve provided is accurate & complete

Thanks for submitting!

Contact Us

Dermot Kavanagh

dfit0410@gmail.com

07867 386 293

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