OVER 70 DECLARATION

APPLICANTS  AGED  70  OR  ABOVE  MUST  SIGN  THE  FOLLOWING  DECLARATION

 

DECLARATION ( Please mark a “x” in one of the following numbers )

 

I hereby declare that:

1.               I am a frequent participant in fitness activities, and am capable of participating in this fitness activity. Therefore, I do not need to produce any medical certificate to prove that I am able to participate in this activity. Shashido Enterprises shall not be liable for any injury or death I may suffer in this activity. I understand that if I have any doubts about my ability, I should consult a doctor before taking part in the activity.

 

2.              I am not a frequent participant in fitness activities. However, I have been examined by a doctor, and certified as physically fit for participating in this activity. A copy of the medical certificate is attached for reference.

 

 

Signature of Applicant____________________________________________________

 

Name of Applicant_______________________________________________________

 

Date _____________________________