Personal Training Par-Q Form

Full name

First NameLast Name

Birth Date

DayMonthYear

E-mail

example@example.com

Phone Number

Format: (000) 000-0000.

Emergency contact

First NameLast Name

Phone number

Format: (000) 000-0000.

Common sense is your best guide when you answer this questionnaire. Please read the questions carefully and answer each one honestly: check YES or NO.

Par-Q

Rows	Yes	No
Has your doctor ever said that you have a heart condition and that you should only do physical activity recommended by a doctor?
Do you feel fain in your chest when you do physical activity?
n the past month, have you had chest pain when you were not doing physical activity?
Do you lose balance because of dizziness or do you ever lose consciousness?
Do you have bone or joint problem (for example, back, knee, or hip) that could be worsen by a change in your physical activity?
Is your doctor currently prescribing drugs (for example water pills) for your blood pressure or heart condition?
Do you know of any other reason why you should not do physical activity?

I have read, understood and completed this questionnaire. Any questions I had were answered to my full satisfaction

Initials

1. Participation in any tests and future exercise is voluntary. All aspects of the programme will be fully explained to you before commencement.

2. You are free to deny consent or withdraw consent at any time after consenting.
3. It is your full responsibility to inform your trainer of any difficulties you perceive or experience as well as any changes to your physical and medical condition.
4. Any questions you have about future procedures risks or benefits to be expected are welcome. If you have any reservations or doubts, please voice these concerns and ask for an explanation or clarification.
5. You consent to being aware of your own health and physical condition and having knowledge that your participation in this program and fitness testing procedures may be injurious to your health and you are voluntarily participating in exercise and nutrition programme written by the trainer. Having such knowledge, you thereby release the trainer and its representatives, agents, employees and successors from liability for accidental injury, illness or death which you may incur as a result of participating in the said programme. You hereby assume all risks connected therewith and consent to participate in said programme.

6. The trainer will not accept liability for any damage or loss to a client’s personal property brought into the premises being used by the trainer

7. The trainer is not responsible for any closure of the premises used for personal training but will endeavour to find a suitable replacement with adequate notice.
8. All sessions cancelled within 24 hours of the start of the session will be charged (“late cancelled”).
a. Where the client has late cancelled the session up to 1 hour before the session was due to start, the trainer will try to accommodate the client for this session either on the day the session is cancelled, the day of the session or the day after the session was due. All moving of sessions that fall within the late cancellation period remain at the discretion of the trainer.
b. The trainer will not move a session to a day where the client has already booked a session unless the client agrees to come in and be charged for both sessions. This includes where the future session falls outside of the 24-hour period – these sessions cannot be cancelled free of charge and then replaced by a late cancelled session that has been agreed to be moved.

c. If the client cannot make what has been offered then they will still be charged. All moved sessions should be agreed up to 1 hour before the start of the original session.
d. A session that has been late cancelled and moved cannot be late cancelled and moved again.
e. If the client cancels within 1 hour of the start of the session, they will not be offered the opportunity to move the session and will be charged for the session.
9. The time slot for any session that is late cancelled will be made available to other clients and the client will no longer be entitled to that session time.
10. Clients who do not attend sessions without informing the trainer before the start of the session will be charged in full for the session and will not be offered the opportunity to move the session. This is deemed a “no show”.
11. All cancellations of sessions must be made by phone or text.
13. The trainer reserves the right to cancel pre-booked sessions for clients who are deemed to be holding prime booking times but cancel their sessions on a regular basis. Clients will be notified of this at least one week in advance of any changes.
14. Any block of sessions purchased must be used within one year of the initial payment date.
Refunds are only applicable when:
(i) illness inhibits continuation (doctor’s certificate required)
(ii) relocation to an unreasonable commute to Anytime Fitness Corby/Vucenic Performance.

15. You are entitled to receive due care and attention from all your trainer and will be given every opportunity to receive the bookings and services you require.
16. All Clients must conduct themselves in a respectful manner whilst training and communicating with the trainer. Any Client who acts in an intimidating, abusive, violent or disrespectful manner may be ejected from the trainers’ premises, with no recourse for refund of monies already paid.
17. The purchase of any course or product is deemed as acceptance of these Terms & Conditions.

Initials

PERSONAL TRAINING CLIENT FORM

Clients informations - Health questionnaire (Par-Q)

Client informations - Liability waiver (T&Cs)