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RTC Gym - Physical readiness questionnaire

Welcome to the RTC Gym. When you come to the gym it is your responsibility to:

• make sure you are well enough to do unsupervised exercise on that day, and
• always work within your ability - which may vary on different days

We do not have qualified fitness staff on site and use of the gym is unsupervised.

Please answer the following questions and and think whether you should see your GP (or other medical professional) before exercising at the RTC Sports Gym.

At the end of the document you must either:

• A. Declare yourself well enough to participate in unsupervised exercise, or
• B. Declare that your doctor has confirmed you are well enough to exercise unsupervised.

If you have prescription medications which you should carry with you, you must bring them on each visit. (Inhalers, GTN spray etc.)

Full Name {name} D.O.B. {dob}

A. I declare myself well enough to do unsupervised exercise and will tell the centre staff if anything changes.

B. My GP has confirmed it is suitable for me to do unsupervised exercise at the RTC Gym.

Please show whether a doctors letter is supplied Yes No

Signed

Date {sign_date}

RTC Sports is a charity registered in England and Wales, No. 1151355.

Registered as a company limited by guarantee in England and Wales. No. 5969860.

Registered office: RTC Sports Centre, Otterburn, Northumberland, NE19 1HE.

RTC Gym Membership Agreement

Here at the RTC Sports and Leisure Centre, we recognise our duty of care to everyone who uses our facilities and want them to enjoy themselves in a safe and healthy environment. Please take a moment to read and take note of a few things which we think will help you to do just that.

Prior to being permitted to use the gym you will have to do the following:

• Complete the online gym membership process
• Complete a physical readiness questionnaire - for your safety and welfare you should consider whether to take medical advice before participating in exercise here.
• Undergo a short introduction to the gym with an RTC staff member, trustee or volunteer.

  This is not a Fitness Induction as the staff are not qualified fitness instructors and cannot advise you on fitness training. You will be shown around the facility and the basic equipment set ups and instructions will be shown to you to ensure you understand how to use the equipment safely. You will also be given information about our associated facilities.

• You will be asked to confirm you have read and understand this information and will follow guidelines set out by us.
• The minimum age for gym use is 14

  14 and 15 year olds must be accompanied by a fully paid up adult member (aged 18 or over) at all times. Under 16s are not permitted to use the weight machines or free weights.

Keeping yourself and other users safe

• Our gym is available to members 24 hours a day 7 days a week.
• It is not a supervised facility and there will be times when no staff members are on site.
• We suggest that you always have a mobile phone with you in case you require assistance, feel unwell, have an accident, or just feel unsure of your safety in any way.
• Do not exercise beyond your ability.
• If you have any medical condition, or develop any new symptoms you must seek advice from a relevant medical professional.
• You must not carry out any exercise or work at an intensity that you have been asked to avoid.
• If you feel ill while using the facilities here, you must stop exercising and seek assistance.
• Keep hydrated while exercising. We supply a water machine but ask you to bring your own bottle.
• There is a first aid kit located in the gym, please inform us if you use anything from this so we can refill as needed.
• There is an Emergency Defibrillator located on the outside western wall of the lounge area.

  In the event you need to call 999, you may be instructed by the operator to use this. Please note that you cannot access the defibrillator in any other circumstances.

• If you see or hear anything at all that makes you concerned about your safety or the safety of others (especially minors) please speak to the Centre Manager or another member of staff if available.

  Manager contact number is 07739608171 or call 999 for emergency services.

Using the equipment

Our equipment is regularly serviced and maintained. If, however, you identify a fault or problem please enter the details in the book provided or advise a member of staff if one is present. The book hangs on the notice board. We hope you enjoy your workout and benefit from the exercise while showing consideration to other users.

• Machines should be wiped down after use using the disposable wipes provided.
• Always sign in on arrival, and out when leaving. This helps us monitor and report usage to Sport England and other funding organisations.
• Please turn all lights off if you are last person in (including toilets) to reduce energy costs
• In the interests of security, please ensure the door is fully closed and do not give the pass code out to anyone. You pay to use these facilities, why should others get in for free?

Failure to comply with any of the above may lead to you being asked to leave the premises and membership can be withdrawn without refund.

I confirm I have read and understood this information sheet and will comply with the requirements set out in it. If the member is aged under 18 then an adult with parental responsibility must counter-sign this agreement.

Signature:  

Date: {sign_date}

RTC Sports is a registered charity in England and Wales (1151355). Registered as 
a company limited by guarantee in England and Wales No.5969860. Registered 
office: RTC Sports Centre Otterburn Northumberland NE19 1LL