Please print, and sign before your lesson or party
Partipole is a group fitness pole dancing lesson designed for apparently healthy adults.
I also have been advised that the consumption of alcohol before or during the lesson is not
recommended and that any injury caused to myself or others as a result of this is solely
I have no medical history that prevents me from taking part in any physical activity, I am not
pregnant or have had a baby in the last 6 weeks and do not know of any other reason why I
should not take part.
Due to the nature of this type of exercise I may experience some slight bruising or chaffing
from the pole and understand that Partipole accept no responsibility for any injury sustained
as a result of me taking part in this lesson.
I understand that I am taking part in this Partipole lesson voluntarily and I do so entirely at my
own risk, I am over 18 years of age and am not part of the Respect (youth inclusion) project.
Please print, read and sign then hand this to your Partipole instructor before taking part, thank you