Breadcrumb Home Gym Gym Application Form Gym application form University Email Full Name First Middle Last Role - Select -StaffUndergraduateGraduatePGCE Homerton residence Your Health and Readiness for physical activity. Please read the following questions carefully and answer each one honestly. Please tick if any issues apply to you. Have you ever had any of the following: * Heart problems Low blood pressure High blood pressure Epilepsy Pain in chest when exercising Breathing difficulties or asthma Diabetes Fainting spells Joint problems Back complaints I am on some sort of medication I have another significant illness or have had an operation I have no health concerns If you have answered yes to any of the above questions you may need to consult your doctor prior to exercise. Please read the statements below and agree by ticking the check box. I have read the Rules of the Gym attached to this form and agree to abide by them. I have to the best of my knowledge completed the health questionnaire and in signing this form, I understand that I carry full responsibility for myself in engaging in physical exercise. I have watched the Homerton Gym Induction video which covers safety and use of the gym. For resident students and staff we aim to give access within 1 working day. For non-resident students we aim to give permission within 1 working day of receiving this form and proof of payment. Staff and non residents may pay via their Upay account (www.upay.co.uk/app/) and the booking appears as an event or in the finance office. Latest from The Homersphere 26 April 2024 Nelson Mandela's daughter delight at bust of her father Nelson Mandela's daughter delight at bust of her father 23 April 2024 Nelson Mandela’s legacy continues to inspire at Homerton Nelson Mandela’s legacy continues to inspire at Homerton 23 April 2024 Tackling Post-ICU Challenges: Joanne McPeake illuminates critical care's path forward at Homerton lecture Tackling Post-ICU Challenges: Joanne McPeake illuminates critical care's path forward at Homerton lecture 22 April 2024 Two Homertonians inducted into Moorhouse College Two Homertonians inducted into Moorhouse College 19 April 2024 Welcome from the Senior Tutor Welcome from the Senior Tutor View all
26 April 2024 Nelson Mandela's daughter delight at bust of her father Nelson Mandela's daughter delight at bust of her father
23 April 2024 Nelson Mandela’s legacy continues to inspire at Homerton Nelson Mandela’s legacy continues to inspire at Homerton
23 April 2024 Tackling Post-ICU Challenges: Joanne McPeake illuminates critical care's path forward at Homerton lecture Tackling Post-ICU Challenges: Joanne McPeake illuminates critical care's path forward at Homerton lecture
22 April 2024 Two Homertonians inducted into Moorhouse College Two Homertonians inducted into Moorhouse College