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Stunt Gym Pty Ltd
ABN: 12058673886

All client information is kept strictly confidential



Do you currently or have you ever had any of the following

Please add any other medical information that may be relevant to assist us in teaching you


I have agreed to participate in Stunt Gym activities. The activities include running, jumping, rolling and climbing at height on rope and scaffold, vaulting, agility drills, flips and tricks. I acknowledge that there are significant risks involved in participating in the Stunt Gym classes, which may result in serious injury. The risks include, but are not limited to: abrasions, sprains, bruising, lacerations, bone fractures, joint dislocations and all manner of injuries caused by the equipment and actions of myself and other people.


In consideration of the above mentioned risks and hazards, and in consideration of the fact that I am willingly and voluntarily participating in Stunt Gym activities, I, the undersigned, agree to release and discharge Stunt Gym and any of its employees and volunteers from any and all liability and claims related to, arising out of, or in any way connected to my participation in this program. I agree to indemnify and hold harmless Stunt Gym and any of its employees and volunteers against any liability incurred as a result of injury or loss.


Stunt Gym activities require that I be in good health and have no condition that could endanger my well-being through participation. I will notify Stunt Gym of any such ailments and/or injuries in writing prior to participating in this activity. I agree to inform Stunt Gym immediately if I develop any symptoms relating to Covid-19 or if I or a person I have come into contact with tests positive for Covid-19, and agree to excuse myself from any further training until given written permission to continue from a medical professional.

I acknowledge that I am covered by public liability, however ambulance cover and personal accident insurance are my own responsibility. I acknowledge that, should I wish to be covered by ambulance cover and/or personal accident insurance whilst participating in Stunt Gym activities I will have to purchase it externally at my own cost. I acknowledge that it is the recommendation of Stunt Gym that I purchase both before participating in any activities.

I have read the above waiver and release and by signing it I agree to participate in Stunt Gym activities at my own risk. I fully understand that by signing I am forever giving up, in advance, any right to make claims against the parties I am releasing.


Participants involved in Stunt Gym activities may be photographed and/or videoed. I, the undersigned, hereby give consent to the use of these images on the Stunt Gym website, or in any promotional and/or advertising material produced and published by Stunt Gym.


(Signature of parent or guardian if participant is under 18 years)

Your waiver has been submitted. Thank you!

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