Client information and medical history form

Name*
First Last
Email*
Mobile*
Mobile Emergency Contact
Date of Birth*
DD slash MM slash YYYY
How did you hear about us?
Can you swim
- Yes
- No
- Yes but not confident
Medical Information
Do you have any medical problem? If yes, please specify
* You should always consult your physician or other healthcare provider before starting a new exercise program. I understand that there is a risk of injury associated with participating in SUP lessons. I hereby assume full responsibility for any and all injuries, losses and damages that I incur while attending, exercising or participating in SUP Club Limassol. I hereby waive all claims against SUP Club Limassol, its instructors, or partners of individually or otherwise, for any and all injuries, claims or damages that I might incur. I understand the above and agree to abide.
Please Select
- I voluntarily provided my personal details to SUP Club Limassol.
- I agree SUP Club Limassol will use the information collected to send news about the club activity.
Any personal information received from you will be retained by us and will not be sold, transferred or otherwise disclosed to any third party, unless such disclosure is required by law or court order.
Confirmation*
- I have, to the best of my knowledge, completed the health questionnaire and informed members of SUP Club Limassol staff of any relevant information regarding my health.

Medical Information