Gym Access Permission Request Form

First Name

Last Name

Cambridge University Email address

I have responded Yes to one or more of the questions above and have discussed this with my doctor who has confirmed that they are happy for me to proceed with the proposed programme of exercise.

I have read, understood and accurately completed the above questionnaire and will inform the College if I am aware of any reason why I should not continue to use the equipment, or may need to take the advice of a suitably qualified personal trainer.

I have read, understood and agree to the Pembroke Gym Rules.

I have looked at the instructions for the equipment I intend to use and am confident I understand how to use them safely.

I understand that submission of this form does not grant me immediate access to the room and that permission will be added to my card usually within 2 working days.

I will only use the access on my card to grant myself entry to the gym.

Gym Access Permission Request Form

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