REGISTRATION FORM
Acro Intensive weekend with forma fortis July 2019
Correo *
Name
First name: *
Surname: *
If you would not like your real name to appear on the registrants list on Facebook, please choose a fake one:
Food and accommodation
What kind of accommodation would you like? *
Dietary requirements (e.g. no carbs only meat) *
Please describe briefly your acrobatic experience. *
For how many years are you practising acrobatics? *
Can you do a handstand against the wall for 30 seconds? *
Can you do/hold a solid standing in hands (feet to hand) on/as a standing base? *
Can you do/hold a solid hand to hand on/as a standing base? *
Contact details
Mobile/tel: *
Address (town, street, no) *
Emergency contact
Emergengy  Name: *
Emegengy Mobile/tel: *
Health issues
1. Has your doctor ever said that you have a heart condition and that you should only do physical activity recommended by a doctor? *
2. Do you feel pain in your chest when you do physical activity? *
3. In the past month, have you had chest pain when you were not doing physical activity? *
4. Do you lose your balance because of dizziness or do you ever lose consciousness? *
5. Do you have a bone or joint problem (for example, back, knee or hip)that could be made worse by a change in your physical activity? *
6. Is your doctor currently prescribing drugs (for example, water pills) for your blood pressure or heart conditions? *
7. Do you know of any other reason why you should not do physical activity? *
AGREEMENT OF RELEASE AND WAIVER OF LIABILITY:
By registering to this workshop,
- you recognize that insurance is in the responsibility of the participant and that you have an adequate accident insurance.
- you agree that acrobatics require physical exertion that may be strenuous and may cause physical injury, and that you're fully aware of the risks and hazards involved.
- you verify, and warrant that you're physically fit and that you have no medical condition that would prevent your full participation in this workshop.
- you knowingly, voluntarily and expressly waive any claim you may have against by the organisers and teachers of the workshop (Forma Fortis), for injury or damages that you may sustain as a result of participating in this workshop.
- Tickets are non refundable but you are welcome to sell your ticket if you wouldn't be able to go, preferably offering it to the people on the waiting list first and the person you sell the ticket to must fill in the registration form as well.
Did you read, understood and agree to the terms and conditions? *
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