These forms are for clients that are interested in a personalized training plan, or anyone participating in my group fitness classes. Plans include physical exercise regimens based on your personal goals, nutrition guidance and overall lifestyle suggestions to get you to where you want to be. Additionally, when you start a personalized program, you’ll have weekly check-ins with me to assess your progress!

Please be as thorough as possible when filling out this form for your personal 1-on-1 coaching. The more information I know about you and your routines, the better I can make your plan and the more effective & successful it will be!

These questions are my personal preference for base information so that I can get an idea about your current fitness level and goals. It is likely that I will ask more questions along the way, but this is the starting point for all of my clients!

After you’ve completed the Client Intake Form, please scroll down and also complete the PAR-Q+ form below.

PAR-Q+

Physical Activity Readiness Questionnaire for Everyone.

The PAR-Q+ will tell us if it is necessary to seek further advice from your doctor before becoming more physically active. I have provided the initial General Health questions below.

Please answer the following questions carefully and answer each one honestly, with either Yes or No.

If you answered NO to all of the PAR-Q+ questions above, you are cleared for physical activity. Please sign your name in the PARTICIPANT DECLARATION box.

PARTICIPANT DECLARATION

If you are less than the legal age required for consent or require the assent of a care provider, your parent, guardian or care provider must also sign this form.

I, the undersigned, have read, understood with to my full satisfaction and completed this questionnaire. I acknowledge that this physical activity clearance is valid for a maximum of 12 months from the date it is completed and becomes invalid if my condition changes. I also acknowledge that the community/fitness entity may retain a copy of this form for its records. In these instances, it will maintain the confidentiality of the same, complying with applicable law.

If you answered YES to any of the General Health questions above, please look out for additional forms from me as we will need to assess your current health situation. I will be sending the rest of the questionnaire via email if necessary, after receiving your submission.

Link to PAR-Q+ form: http://eparmedx.com/wp-content/uploads/2013/03/PARQPlus2019ImageVersion2.pdf

WAIVER AND RELEASE

Because physical exercise can be strenuous and subject to risk of serious injury, I urge you to obtain a medical examination from a doctor before using any exercise equipment or participating in any exercise activity. You agree that by participating in physical exercise or training activities, you do so entirely at your own risk. You agree that you are voluntarily participating in these activities and use of these facilities and premises and assumed all risks of injury, illness, or death. We are not responsible for any of the aforementioned risks or loss of your personal property.

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 the trainer or instructor (Teigan Schentrup) 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 the trainer or instructor for personal injury or property damage.

To the extent that statute or case law does not prohibit releases for negligence, this release is also for negligence.

If any portion of this release from liability shall be deemed by a Court of competent jurisdiction to be invalid, then the remainder of this release from liability shall remain in full force and effect and the offending provision or provisions severed here from.

By signing this release, I acknowledge that I understand its content and that this release cannot be modified orally.