CONTACT US

Below you will find a contact form for our MCMA Training Centres. We recommend visiting our Timetable pages to see what classes are available in Watford, South Oxhey, Northwood and Hemel Hempstead. Please indicate which centre you are interested in so we can help and guide you efficiently towards your class of choice.

You can also WhatsApp us on:

07822 014 515

info@moderncombatmartialarts.com

Find Us

Hemel Hempstead

The Active Dacorum Hub, Sports Pavilion, Redbourne Road, Hemel Hempstead, HP2 7BA

Watford

MCMA Watford Car parking on site available. At busy times please use surrounding area street parking or local car parks. Please check signage.

South Oxhey

Northwood

Health Screening and Client Information Form

Please complete this form to book your trial lesson.

Regular physical activity has many health beneﬁts, however, some people should check with their doctor before they start. When planning to undertake physical activity, you should start by answering the questions below. If you are in any doubt, consult with your G.P. before commencing exercise.
Please read the questions carefully and answer them honestly by choosing YES or NO.

Name

Date of Birth

Number

Please Choose Trial Lesson

Has your doctor ever said that you have a heart condition and that you should only do physical activity recommended by a doctor?

Do you feel pain in your chest when you do physical activity?

In the past month, have you had chest pain when you were not doing physical activity?

Do you lose balance because of dizziness or do you ever lose consciousness?

Do you have a bone or joint problem that could be made worse by a change in your physical activity level?

Have you ever had any problems with your back?

Is your doctor currently prescribing any medication for your blood pressure or a
heart condition?

Is there any family history of heart disease, stroke, raised cholesterol or high blood pressure?

Do you suﬀer from diabetes/epilepsy/asthma?

Are you pregnant, or have you given birth in the last six weeks?

Do you have, or have you had any illnesses recently?

Have you recently had surgery?

Do you know of any other reason why you should not do physical activity?

What are your aims for exercising?

Present and past activity levels, how often and what type

Disclaimer

I have read and fully understood the Health Screening Questionnaire. I conﬁrm that, to the best of my knowledge, the answers are correct and accurate. I know of no reason why I should not participate in an exercise workout. I understand that I would be using the Health & Fitness facilities entirely at my own risk and waive any legal recourse for damages to myself or property arising from my participation.

I am aware of the physical nature of Martial Arts and I understand that by its nature there may be some risk involved. I agree that I/my child will immediately discontinue further participation if at any time the activity is deemed to be unsafe. I agree to waive any claim against the school and its representatives for injury arising from or during practice, private classes, regularly scheduled classes, grading, testings, exhibitions, demonstrations and contests and I understand that any medical treatment given will be of a first aid treatment only.

By pressing 'Submit' I declare that I have understood and answered all of the above questions honestly. I understand that I should not exercise if I feel unwell and that if my health changes I should inform my instructor.

Please leave this field empty.