Be added to our MVP List to find out how to Enlist into the Academy in July 2021!
  • Date Format: MM slash DD slash YYYY
  • Example: Shift Work, Feeling Self-Conscious etc
  • If Yes, please explain why.

    A vital part of what we do is making sure you are safe at all times while participating in our sessions. It is with this in mind that should you have any medical illness or condition that you are aware of and / or is currently being managed by your medical practitioner, to bring along with you the appropriate medical clearance(s) for us to get started! Please indicate below should you be aware of any condition applicable to you.
    Check the applicable boxes
  • If "Yes", please provide more information for our Coaches

    I warrant to The Empire Bodyshop that all information I have provided on this form is of a true and correct nature. I accept that I will not have any claim of any nature against The Empire Bodyshop for any illness, injury or adverse change in medical condition or state of health arising directly or indirectly from any program or advice provided by or carried out preparatory to or as part of any program I undertake whilst under the supervision or instruction of The Empire Bodyshop. Any rights granted to me by law which are not capable of change by agreement remained unaffected by the terms of this agreement. I understand that The Empire Bodyshop will be utilising the above mentioned information for the purposes of determining suitable candidates for the 2021 Scholarship intake. I declare that if selected, my best efforts will be applied in all situations to demonstrate my commitment to this program & I understand that The Empire Bodyshop Coaches reserve the right to remove any Applicant from the Scholarship Program in the event of serious misconduct or behaviour in contradiction to The Empire Bodyshop's Values and Culture.