top of page

Gym Safety Induction Checklist

Contact Details

Instruction in the following subjects has been given to the above named

Code of Practice

Fire Drill / Emergency evacuation

First Aid / Medical Emergency

Layout of the Lache Community Centre

Accident / Near Miss reporting

Smoking Policy

Specific Hazards / Housekeeping


Limitations for Training (see booklet)

Fitness Equipment (by Supervisor)

Disabled Access

Specific Hazards

Alcohol and Drugs Policy

General Conduct

Vehicle Parking


I confirm that I have recently completed a “Heart Rehabilitation” course or am in receipt of a letter from my doctor or have completed a Self Declaration and am fit to use this facility. I also confirm that I have completed the above Safety Induction and have had all items fully explained to me.



Hold/drag mouse to draw signature

 Signature of member



Final Submit


Your content has been submitted, click exit below

An error occurred. Check you didn't miss a field above?

Your form is okay, click Final Submit
bottom of page