SKIFIT Questionnaire
All information gathered by Meriski is totally confidential and will not be used in any way other than prescription of exercise for skiing.

This questionnaire enables us to customise your skifit plan so that everything is set at the right level and personalised to you and your skiing goals for the coming season. The plan tailored around you having more fun with skiing whatever your goals. The training will feel manageable and will be specifically customised to you.
Email address *
First Name *
Or name you prefer to be called.
Surname *
Contact email *
Preferably one you can check from home as well as work.
Phone Mobile (0) *
Alternative number
Please include evening land line number.
Skype name
Physical Address
Medical
Date of Birth *
dd/mm/yy
Have you suffered from any other condition or injury in the past that has affected or may affect your ability to ski?
If so please give details.
Have you suffered from a skiing injury?
If so please give details. Include when and how it happened.
How much do you weigh right now? *
How much do you think you should weigh? *
What is your height in centimetres? *
How would you rate your flexibility? *
Very inflexible
Very flexible
Skiing Specific
This is totally personal to you and what you class as an "amazing day out on the slopes".
What is the hardest terrain you ski when on holiday? *
Green, blue,
Required
How would you rate your skiing style? *
Cruisy. Ski a little and then take some photos.
Aggressive. Get to the bottom as fast as you can.
What would be your idea of the perfect ski run. What type of snow difficulty and terrain etc... *
Do you have any ski specific goals? *
Goals are totally individual. You might want to ski pain free without fatigue, comfortably ski a black run or simply master the snow plough.
Exercise History
Current exercise *
Please indicate your current, "typical week of exercise". Include walking, golf, horse riding and any physical activity you have been doing recently or are likely to be doing.
How many times a week and when during the week would you be able to do some SKIFIT training? *
SKIFIT exercise can include walking, cycling, gym work, home based exercises and anything else that will help you have more fun and less risk of injury when skiing.
When would you like your training program to start? *
When is your next ski holiday booked for? *
Equipment *
List all the equipment you have that can be used for exercise. Bike, gym access, running shoes, swimming pool access etc.
Are you currently preparing for or would like to prepare for any sporting activities or events outside skiing? *
This could be a long hike with friends, a half marathon, a cyclosportive or any other fun event or challenge.
Can you think of any other information that might help in devising your personalised Ski Fit Programme? *
Including any logistics or travel, that might mean you'll be out of your usual routine.
Waiver
Please read the following and type your name in the space provided at the bottom of the last page. By typing your name you indicate your understanding and agreement of the following text.

Smart coaching limited requires that you consult with your physician before following any training instructions you receive through Smart Coaching Limited. Neither Smart Coaching limited nor the coaching staff are licensed medical care providers and represent that they have no expertise in diagnosing, examining, or treating medical conditions of any kind, or in determining the effect of any specific exercise on a medical condition. Smart Coaching Limited and its coaching staff are not prescription systems and are not intended to be a substitute for professional medical advice, diagnosis, or treatment. You should understand that when participating in any exercise or exercise program, there is the possibility of physical injury and/or death.

You should never disregard medical advice or delay in seeking it because of something you have read on the smart coaching limited web site or news letter. Smart coaching limited and coaching staff are not responsible for any health problems that may result from training programs you receive from them. If you engage in any training program you receive through smart coaching limited or coaching staff, you agree that you do so at your own risk, are voluntarily participating in these activities, assume all risk of injury to yourself, and agree to release and discharge smart coaching limited and coaching staff from any and all claims or causes of action, known or unknown, arising out of the actions of smart coaching limited or coaching staff. You agree to indemnify and hold harmless smart coaching limited and coaching staff for any loss, liability, claim, damage, and expenses (including reasonable attorneys' fees) brought by you, anyone acting on your behalf, or any third party, in any way arising from or in connection with your use of the information or services you receive through smart coaching limited or it's coaching staff.

Smart coaching limited and it's coaching staff are not responsible for the accuracy, reliability, effectiveness, or correct use of information you receive through the smart coaching limited web site, or for any health problems that may result from training programs, products, or events you learn about through smart coaching limited or associated coaching services. smart coaching limited and coaching staff do not certify content or endorse any information supplied by other companies for our Web site.

PLEASE NOTE: Not all exercises are suitable for everyone. Before you begin following any training instructions you receive, you should have permission from your physician to participate in vigorous training. If you ever feel discomfort or pain, do not continue. The instructions and advice presented by smart coaching limited are in no way intended as a substitute for medical consulting.

Limitation of Liability: smart coaching limited, coaching staff, and their affiliates and sponsors are neither responsible nor liable for any direct, indirect, incidental, consequential, special, exemplary, punitive or other damages arising out of or relating in any way to the smart coaching limited Web site or the coaching services provided by Smart Coaching limited or coaching staff. Your sole remedy for dissatisfaction with the services provided is to stop using those services.

Waiver and Indemnity: Your use of any services and information obtained through smart coaching limited, including but not limited to the coaching services of our coaching staff, certifies that you have read this Agreement and hereby for yourself, your heirs executors and assigns, waive, release and hold harmless smart coaching limited and coaching staff from any and all claims, demands, liabilities, rights or causes of action arising out of or in connection with participation in activities proscribed by the aforementioned parties.

You agree to defend, indemnify, and hold smart coaching limited, coaching staff and their officers, directors, employees, agents, licensors, and suppliers, harmless from and against any claims, actions or demands, liabilities and settlements including without limitation, reasonable legal and accounting fees, resulting from, or alleged to result from, your violation of the terms and conditions of this Agreement.

If you are going to participate in one of smart coaching limited's training programs, you need to start by answering the seven questions in the box below. If you are between the ages of 15 and 69, this will tell you if you should check with your doctor before you start. If you are over 69 years of age and you are not used to being very active, check with your doctor. Common sense is your best guide when you answer these questions. Please read the questions carefully and answer each one honestly. Make a note of which questions (if any) you answer YES to.
Please answer the following [Has your doctor ever said that you have a heart condition and that you should only do physical activity recommended by a doctor?] [Has your doctor ever said that you have a heart condition and that you should only do physical activity recommended by a doctor?] [Has your doctor ever said that you have a heart condition and that you should only do physical activity recommended by a doctor?] *
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 pain in your chest when you do physical activity
In the past month, have you had chest pain when you were not physically active?
Do you lose balance because of dizziness or do you ever lose consciousness?
Do you have a bone or joint problem that could be made worse by a change in your physical activity?
Is your doctor currently prescribing drugs for your blood pressure or heart condition?
Do you know of any other reason why you should not do physical activity?
If you answer yes to one or more of these questions... [By ticking yes you understand and agree to all the terms and conditions set out in this waiver.] [By ticking yes you understand and agree to all the terms and conditions set out in this waiver.] [By ticking yes you understand and agree to all the terms and conditions set out in this waiver.] *
Talk with your doctor by phone or in person BEFORE you start becoming much more physically active or BEFORE you contact us or begin training on a training program. Tell your doctor about the PAR -Q and which questions you have answered YES. You may be able to do any activity you want - as long as you start slowly and build up gradually. Or, you may need to restrict your activities to those which are safe for you. Talk with your doctor about the activities you wish to participate in and follow the advice. Find out which programs are safe and helpful for you. NO to all questions If you answered NO honestly to all PAR-Q questions, you can be reasonably sure that you can: Start becoming more physically active – begin slowly and build up gradually. This is the safest and easiest way to go. Start using a Smart coaching limited training program, provided you complete this PAR-Q and the subsequent medical / training questionnaire honestly. DELAY BECOMING MUCH MORE ACTIVE: If you are not feeling well because of a temporary illness such as cold or fever, wait until you feel better OR If you are or may be pregnant – talk to your doctor before becoming more active. PLEASE NOTE: If your health changes so that you then answer YES to any of the above questions, tell your Coaching and/or health professional. Ask whether you should change your plan. I ACKNOWLEDGE THAT: During the duration of my training program (or whilst following the components within the training program) both my property and my person shall be at risk and I will not hold www.smartcoach.co.nz / Smart coaching limited Pty Ltd liable for any personal injury or loss of property. I do not have the right of action against www.smartcoaching.org / Smart coaching limited Pty Ltd or any employee or agent of these parties in respect of any injury, loss or damage occurring during the period of my program (or whilst following the components within the training program). I have read, understood and completed this questionnaire. Any questions I had were answered to my full satisfaction by smart coaching limited staff (email: silas@smartcoaching.co.nz if you need to clarify any of the above).
Yes
No
By ticking yes you understand and agree to all the terms and conditions set out in this waiver.
Photo of you to personalise your website, send to: silas@smartcoaching.org
Looking at a photo of yourself on the slopes is great for motivation preseason. If you do have a photo of yourself we could use to personalise your information page, that would be fantastic! If you don't have a photo of you skiing then any cool photo of you being active would be great. Please email your photo to silas@smartcoaching.org
Thank you for filling in this form. We look forward to helping you get the most out of your holiday and your skiing.
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