Health Form

First name

Last name

Phone

Email

Birthday

Day

Month

Year

Does your midwife/doctor agree to your participation in pregnancy exercise classes?

Please list all medical aspects of your general health/pregnancy/postbirth condition:

I agree that I will not exercise when I am unwell, including coughs and colds. I agree that I will check with my FitMama coach if I am unsure if I should exercise. I agree that I will report any change in my wellbeing to my FitMama coach.

I agree that I will not bring sick children to any session that welcome children.

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