Disclaimer forms

Please note that you will be asked to fill a form previous to your first session.

If it is too hard or if it hurts, you can stop!

You may rest at any time during the class. It is important that you to listen to your body, and respect its limits on any given day.

Be Kind to yourself and enjoy your class.

Professional Disclosure Form and Release

Please read carefully
(find health questionnaire at the bottom of the page)

DISCLOSURE AND RELEASE FORM
I am delighted to have you as a Circus Skillls student. The following information will help you get the most out of your classes and clarify my role as a circus skills trainer.

Many thanks.

All exercise programs involve a risk of injury. By choosing to participate in my
classes, you voluntarily assume a certain risk of injury. The following guidelines will help you reduce your risk of injury.

Listen to the class instructions carefully. At the same time if the instructions do not feel right for you in your body, or cause any pain, then use your own authority to not continue.
Let your instructor or parents know if you feel any pain or the activity doesn’t feel right in your body. It is your body you know how it feels.
If you are not sure about an exercise please ask.
Work gently, respecting your body’s abilities and limits. Our bodies are all different.
It is always advisable to consult with your physician or GP before embarking on any exercise program. You must complete the form and inform me of any health condition(s) that could be affected by exercise.
As a student it is solely your responsivity to monitor each activity offered and determine whether it is appropriate to participate. Though I am your circus skills trainer, you remain primarily responsible for your safety and wellbeing.
Please do not put yourself at risk. Practice carefully with awareness of other people around you.
Props must not be used as weapons, for things such as play fighting nor for hitting or batting.
If someone has a prop that you would like to use, please ask kindly if you could have a turn after they finish.

By signing this form, you hereby release Andrea Aguirre Betancour and ACE Circus from any and all liability for injuries.

By booking this class therefore you state that you have read, understood and agree to the content of this Professional Disclosure Form and Release.

Health Questionnaire

Please take a moment to fill out the form.

Parent/guardian/carer's full name

Child's full name

Parent/guardian/carer's phone number

DOB of participant

Have you or your child lost conciousness in the last 12 months?

yes

Do you or your child have any health or medical conditions that I might need to know about? (example, injuries, heart conditions, diabetes, recent surgeries, back pain ...?)

yes

If you answered yes to any question, please elaborate. Or write down any additional comments.

Today's date

I declare that the information I have provided is accurate and complete

I declare I have read the Profesional disclousure form and release

A picture will be taken at the end of the class, which might be used in our website, please state if you authorise your child to join in the photo

yes

Thanks for submitting!

Disclaimer forms

Professional Disclosure Form and Release

Please read carefully (find health questionnaire at the bottom of the page)

Health Questionnaire

Please read carefully
(find health questionnaire at the bottom of the page)