Health declaration
Last updated: October 2026
Before the first session every trainee fills in and signs a health declaration. Print the form, fill it in and bring it, or photograph it and send it on WhatsApp. The form is never submitted through the site.
Full name
Date of birth
Phone
Emergency contact and phone
Mark yes or no for each question:
- Has a doctor told you that you have heart disease or high blood pressure?YesNo
- Do you feel chest pain at rest, in daily activity or during exertion?YesNo
- Have you lost balance from dizziness, or lost consciousness, in the past year?YesNo
- Have you been diagnosed with another chronic condition (e.g. diabetes, asthma, epilepsy)?YesNo
- Do you take regular medication? (including blood thinners)YesNo
- Do you have a bone, joint or soft-tissue problem that activity could worsen?YesNo
- Have you had a concussion or head injury, or do you have an eye condition (e.g. retinal)?YesNo
- Has a doctor told you to exercise only under medical supervision?YesNo
- Are you pregnant?YesNo
If you answered yes to any question, a doctor's approval is required before training starts.
I declare that these details are true, that I have no medical limitation I haven't listed, and that I will tell the coach about any change.
Trainee signature
Date
Risk and responsibility
- Boxing is a contact sport. Even pad work without sparring carries a risk of injury, like any physical activity.
- The trainee is responsible for telling the coach in advance about any medical condition, injury, pregnancy or change in health, including during the program.
- The trainee may stop a session at any moment. The coach may stop a session if concerned for the trainee's safety.
- Sessions are for women aged 18 and over.