Please Fill Out Before Attending Your Initial Consultation

Functional Patterns Melbourne client WaIver and Pre-Session Information

Please fill out the medical waiver and questions in our form below. You can also read more about our cancellation policy. This streamlines the process for your session and lets us know if we have to refer you to a medical professional prior to undertaking any training. 

If you have any questions about the below, please feel free to contact us to discuss. We look forward to seeing you and helping you to live intentionally, not habitually.

Please click ENTER once you have completed this form
(DD/MM/YY)
Please include any additional notes here for the listed items above
In the event you do not attend your scheduled appointment, with no reasonable explanation, you will incur a 100% payment fee for the session. This policy ensures other clients are able to access our services rather than being put on a waiting list or turned away. Please type "I agree" below.
Physical exercise can be strenuous and subject to risk of serious injury. We urge you to obtain a physical examination from a doctor before using any exercise equipment or participating in any exercise activity.

You agree that by participating in physical exercise or training activities, you do so entirely at your own risk. Any recommendation for changes in diet including the use of food supplements are entirely your responsibility and you should consult a physician prior to undergoing any dietary or food supplement changes.

You agree that you are voluntarily participating in these activities and use of these facilities and premises and assume all risks of injury, illness, or death.

We, the trainers at Functional Patterns Melbourne are also not responsible for any loss of your personal property.

You acknowledge that you have carefully read this "waiver and release" and fully understand that it is a release of liability.

You agree to release and discharge the trainer or instructor from any and all claims or causes of action and you agree to voluntarily give up or waive any right that you may otherwise have to bring a legal action against the trainer or instructor for personal injury or property damage. To the extent that statute or case law does not prohibit releases for negligence, this release is also for negligence.

If any portion of this release from liability shall be deemed by a Court of competent jurisdiction to be invalid, then the remainder of this release from liability shall remain in full force and effect and the offending provision or provisions severed here from.

By signing this release, I acknowledge that I understand its content and that this release cannot be modified orally.

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+61 458 904 881

melbourne@functionalpatterns.com 

2 Pearson Street
Brunswick West, VIC
Australia

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