Name
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First Name
Last Name
Please let me know an emergency contact (name) and phone number:
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What's your phone number?
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(###)
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####
What's your mailing address?
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Address 1
Address 2
City
State/Province
Zip/Postal Code
Country
When's your birthday?
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MM
DD
YYYY
Broadly speaking, what are your personal training goals?
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Goals shift and change continuously, so do not worry about keeping this answer static.
What is your current occupation?
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Do you partake in any recreational activities (tennis, cycling, running, etc.)?
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Do you have any hobbies (reading, writing, gardening, etc.)?
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Do you have any mental health conditions or life changes (recent or in the past) that might impact your movement practice?
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(if no, please put n/a. If yes, please elaborate)
Has a medical doctor ever diagnosed you with a chronic disease, such as coronary heart disease, hypertension (high blood pressure), high cholesterol, or diabetes?
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Will you be requiring a W9 form from me for tax filing?
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[example: your insurance needs my EIN to confirm reimbursement]
Cancellation Policy/No Refunds
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Clients must reschedule personal training sessions at least 24 hours in advance . If a training session is canceled less than 24 hours before the scheduled start time, the client understands that they forfeit any fees paid. It is understood that no personal training refunds will be issued for any reason.
Training Services Policy
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Personal Training is described and serviced differently by every trainer. Training varies depending on such things as the pedagogy of the trainer and goals of the client. Personalities of both parties also affect training methods. Understand that the methods I use as a trainer will vary person to person, and often shift within cycles of training.
Our sessions will act as a space to gain both experience and knowledge of training methods specific to your needs. Training does not occur in a vacuum; what you learn in sessions can and should be applied to your everyday life and movement practices. With that in mind, understand that personal training is an investment that extends beyond our time together.
The suggested frequency of sessions varies depending on the clients’ needs and availability. If we are unable to meet for the suggested weekly frequency, I will provide you with workouts to help you continue your practice throughout the week. These workouts will require trial and error, feedback, and revisions. Therefore, our communication will need to be open and frequent regarding your workouts.
Training takes time, dedication, and evolution. Training/movement is an on-going and ever-changing practice, just as your life is. As much as we focus on your specific needs and goals, understand that results cannot be guaranteed.
Changes often take months to be realized and developed. If after time you find that the current training methods do not serve you, there are steps that we can take to address any concerns and redirect our focus. You can speak with me about what you hope to experience, and I can alter our methods, or I can refer you to another trainer.
Disclosure of Physical Conditions / Informed Consent
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Training has benefits and risks associated with it. Every effort will be made to assure your safety, however, as with any exercise program, there are risks, including but not limited to: increased stress on your cardiorespiratory system and chance of musculoskeletal injuries. Please review the below responsibilities and acknowledgements that come with the benefits/risks of training.
Client responsibilities:
● Fully disclose any health issues or medications that are relevant to your participation in exercise.
● Inform me if there are exercises with which you do not feel comfortable.
● Stop exercising and speak with me about any unusual feelings you may experience during exercise.
● Clear your participation in training with your physician.
Client acknowledgements:
● You acknowledge that your participation is completely voluntary.
● You understand the potential risks involved in your exercise program.
● You understand that the achievement of health or fitness goals cannot be guaranteed.
● You have had a voice in planning and approving exercise methods.
● You have been able to ask questions regarding any concerns, and have had those questions answered to your
satisfaction.
Release/Indemnity
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Because health and well-being are affected by many factors, not just your exercise program, in volunteering to train with me, you agree to assume full responsibility for your health and well-being, and release me from any related liability. It is recommended that you undergo a thorough medical evaluation prior to beginning any exercise program. You understand that training sessions are not medically supervised activities, and therefore, you exercise at your own risk. You agree that, to your knowledge, you have no limiting physical conditions that would preclude you from participating in an exercise program based on your needs, that you will let me know of any relevant changes to your health, and that you understand the risks involved with your participation in an exercise program.
By checking the box below, you agree to defend, indemnify, and hold me harmless from, and covenant not to sue me for, any claims and costs (including reasonable attorneys’ fees) arising out of or related to, your participation in our training program, your conduct or interactions with other clients, and your acts or omissions.
