I hereby agree that I (or my adult carer/parent with responsibility for me) take(s) full responsibility for myself and any injuries that may occur during the Boxercise session provided by Gill Dawson.

I have made Gill aware of any issues that may impair my ability to react or move in certain ways.

I am aware that Boxercise is a non-combat exercise session.

I will be landing punches/elbows on focus mitts and kicks and knees on focus mitts or kick shields.

Some equipment may be used such as -swim noodles, balls bean bags cones etc. These will be used after an explanation or demonstration.

I will ensure that myself or the person I am signing this for has appropriate footwear and clothing to take part safely.

I will ask Gill if I am unsure or unsteady on any of the movements and understand she will provide alternatives where possible for me to continue the exercise.

I agree to let Gill know if I have any problems or feel ill in the session.