Janelle Chow Coaching's "Getting to Know You" Evaluation and Waiver for Doodles and Deadlifts LLC

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I am so excited to begin working with you as your Personal Trainer and Coach for Doodles and Deadlifts LLC!

For your convenience, all of our initial "paperwork" is included below. This will allow me to begin planning a program and workout that will help you reach your goals as quickly as possible. The following online form should take you less than 30 minutes to complete.

Once I receive this completed form from you, we can book in our first coaching appointment and can get to work. If you have any questions, just ask me!

Full Name *

Email *

Date of Birth *

YYYY

PAR-Q

This form acts as a PAR-Q (Physical Activity Readiness Questionnaire) that will help determine whether or not it's safe for you to begin a new exercise program. Please answer the following questions honestly, and provide as much detail as possible where applicable.

Has your doctor ever said that you have a heart condition and that you should only do physical activity recommended by a doctor? *

Yes

In the past month, have you had chest pain when you were not doing physical activity? *

Yes

Do you lose your balance because of dizziness or do you ever lose consciousness? *

Yes

Is your doctor currently prescribing drugs (for example, water pills) for your blood pressure or heart condition? *

Yes

Do you know of any other reason why you should not do physical activity? *

Yes

If you answered YES to the previous question, please explain in detail here:

COACHING AGREEMENT

With my help as your Personal Coach, you are going to greatly improve your ability to accomplish your health goals faster, safer, and with maximum benefits. Plus, the tools and strategies you will learn during our time working together can be used for a lifetime.
Just as would be the case if you were working with a personal trainer at a gym or a nutritionist in a medical office, the following expectations must be met with regards to our coaching sessions:

1. Coaching sessions that are not rescheduled or cancelled 24 hours in advance will result in forfeiture of the session and/or a loss of the financial investment at the rate of one session.

2. Clients arriving late to a coaching session will receive the remaining scheduled session time, unless other arrangements have been previously made.

3. If there is no time commitment in the program, to end our client-coach relationship, simply provide written notice (email) at least 30 days in advance. If participating in a three month program, three months is the length of the commitment.

I have read and agree to the Coaching Agreement and agree to it's terms: *

Yes

Required

WAIVER OF LIABILITY

It's important that you understand that any form of physical exercise can be strenuous and subject to risk of serious injury. You are urged to obtain a physical examination from a doctor before participating in any exercise activity, including those provided by Janelle Chow and Doodles and Deadlifts LLC.

You agree that if you engage in any physical exercise or activity, you do so entirely at your own risk. This waiver and release of liability includes, without limitation, all injuries which may occur as a result of: (a) your participation in any activity or participation in any exercise routine and (b) instruction, training, supervision, or dietary recommendations by Janelle Chow and Doodles and Deadlifts LLC.

You acknowledge that you have carefully read this “waiver and release” and fully understand that it is a release of liability. You expressly agree to release and discharge Janelle Chow from any and all claims or causes of action and you agree to voluntarily give up or waive any right that you may otherwise have to bring a legal action against Janelle Chow for personal injury or property damage. By signing this release, you acknowledge and understand its content and that this release cannot be modified orally.

I have read and agree to the Coaching Agreement and agree to it's terms: *

Yes

Required

FINAL THOUGHTS AND SIGNATURE

Is there anything else you'd like to share? If so, please do so here:

Signature: Typing your name here indicates that the information you provided is accurate and that you agree to the waiver of liability terms listed above. *

Date: *

YYYY

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