TKO Covid-19 Member Screening

Please note that this form must be on file at Troy Kickboxing Outfit before you will be allowed to take a class. Thank you so much for your support in adhering to Covid-19 CDC guidelines. This waiver will serve as your ongoing agreement to be in compliance with the checklist before attending any classes. If your health or circumstances change, please abstain from classes and contact us.

First Name

Email Address

Last Name

Date of Birth

I agree to the following:

I understand how to use the “6-ft Social Distancing Rule” during all sessions in order to prevent possible spread.

I agree

I will not schedule or attend any classes if I am experiencing any symptoms including the following currently or in the 24 hours prior to scheduling or attending a kickboxing class: A. Fever over 100.4; B. Shortness of breath; C. Coughing

I agree

By checking this box, I will adhere to current Covid-19 CDC guidelines and I do not hold Troy Kickboxing Outfit responsible for any sickness or illness, including but not limited to Covid-19.

Today's Date

Initials

Thank you for your submission.

TKO Covid-19 Member Screening

I agree to the following:

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