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GLIDE Client Questionnaire

IKO/IWO Centre Name - GLIDE

IKO/IWO Instructor ID - 240248

This form enables us to provide you with the right equipment and plan your lesson. It also gives us important emergency contact information and lets us know if you have any medical history that we should be aware of. There is also an important waiver section. Thanks for your time filling it in.

Birthday
Day
Month
Year

Please answer yes or no as to whether you have any of the following medical conditions:

Heart disease, high blood pressure, fainting, dizziness or circulatory problems:
YES
NO
Chest complaints (eg asthma, bronchitis, etc):
YES
NO
Epilepsy, seizures or fits:
YES
NO
Bone or joint injury:
YES
NO
Are you taking regular prescription drugs which might have implications for physical activity?
YES
NO
Has your doctor advised you against strenuous exercise?
YES
NO
Do you have any other medical condition that you feel we should be made aware of?
YES
NO

Please note that we may have to cancel or stop your lesson at any time if, at our discretion, we feel that it may not be safe to continue on medical or other grounds. You must not at any point during your lesson be under the influence of alcohol or drugs of any kind which might impair your abilities. If you require access to medication - we have a dry bag which will be kept on the beach as near to our lesson as practicable and would be happy to pause your lesson at any time.

We can provide the equipment needed for your lesson but if you have your own you are welcome to use it. Please tick any of the items that you will be bringing:
Will you require a male or female cut wetsuit?

We need to know a little about your size not just for wetsuits, etc. but also to help us choose the best size of other equipment for the lesson:

Client Waiver

In consideration for the courses and/or activities utilising the facilities, instruction and equipment of GLIDE, by submitting this form I hereby acknowledge and agree to the following:

  • I understand and acknowledge that kiteboarding, wing SUP and wing foil activities have inherent dangers that no amount of care, caution, instruction, or expertise can totally eliminate. I expressly and voluntarily assume all risk of personal injury or death sustained while participating in these activities whether or not caused by the negligence of the released parties.

  • I agree that I will operate the said kiteboarding, wing SUP or wing foil equipment in a reasonable and safe manner so as not to endanger the lives of persons or property of any individual.

  • I confirm that I am an open water swimmer.

  • I am not under the influence of alcohol or drugs.

  • I am in good health condition and have no medical condition that may interfere with the practice of kiteboarding, wing SUP or wing foil activities. I am not pregnant or nursing. I have no mental impairment that may affect my judgment of danger and information given during the practice of these activities.

  • The school Manager and/or the Instructor has explained to me the risks involved and given me the full opportunity to ask any and all questions about kiteboarding, wing SUP and/or wing foil activities and all of my questions have been answered to my total satisfaction.

  • I acknowledge that I have been given adequate opportunity to read and understand this document, that it was not presented to me at the last minute.

  • I further represent that I am at least 18 years of age or that as the parent or legal guardian I waive and release any and all legal rights that may accrue to me or to my minor child as the result of any injury that my son or daughter (minor) may suffer while engaging in kiteboarding, wing SUP or wing foil activities.

  • I give my consent to the IKO/IWO Instructor or IKO/IWO Center to share my personal information to the IKO/IWO in order to receive my certification.

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