12 Week Body Transformation Challenge Application Form

12 Week Body Transformation Challenge Application Form

Can you please fill out this application form as thoroughly as possible. I need to know any medical history or issues that you have in order to devise your training plans. Form Preview
12 Week Body Transformation Challenge Application Form
  • 12 Week Body Transformation Challenge Application Form

  • About You
  •  -  - Pick a Date
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  • About Your Lifestyle
  • About Your Health
  • If you have ticked any of the above conditions you will need to get written permission from a medical practitioner, stating you are well enough to undergo physical activity.
  • If you ticked two or more of the options above you will need to seek written medical permission clearing you for physical activity for the challenge
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  • Declaration

    The health and medical information provided is true and accurate and to the best of my knowledge.  Whilst I realise that I will be provided with an exercise and weight loss program that is safe and effective, I am choosing to participate at my own risk.

    I declare that I am not pregnant and do not plan on becoming pregnant during the course of the challenge.  If my health, or any other condition changes that would impact any of the above questions, I will advise my trainer and have this updated immediately.

    Disclaimer

    The information provided to me during the 12 week challenge will be useful information on weight loss, healthy eating and exercise and is not intended as a substitute for advice from a medical practitioner or health care provider.  Before starting any weight loss program or exercise you should gain advice or guidance on any health conditions/illnesses.  

    Other Terms

    I understand that all information provided to me will be kept confidential and not shared with others.

    I understand that everyone will lose weight at different rates and so I may lose weight slower or faster than others I have seen.

    Upon signing this application I understand that I am liable for all the costs associated with this challenge, and that no refunds will be available.  The only would be, if a Doctors letter was received advising that you were unable to continue due to a medical condition, at which point ou would be entitled to a pro-rated refund of your remaining program.  

    I have read the above statements and agree to follow the program exactly as outlined by my weight loss consultant.  I have read this application form in its entirity including the declaration, disclaimer and other terms sections and understand the information that has been provided to me....

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    Pick a Date
  • Clear
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