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  • Online coaching enquiry form

    once complete, Stephanie will get in touch with you regarding the next steps
  • 1. Personal Information

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  • 2. Exercise History


  • 3. Health/Medical Information



  • 4. Your Goals


  • 5. Diet & Nutrition

  • 6. Readiness for change

    Please rate each category on a scale of 1-5
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  • 8. Terms & Conditions

    Please read the following:
  • 1. Your responsibilities & Informed Consent:

    a. Disclosure of information - You agree to disclose all health information as requested and keep us updated on any changes to your health. This includes all medical conditions; physical and mental, injuries, allergies, and medication you are taking.

    b. Accepting potential risks – Informed Consent - During your exercise program, every effort will be made to assure your safety. However, as with any exercise program, there are risks. In volunteering for this program, you agree to assume responsibility for these risks and waive any possibility for personal damage. You also agree that, to your knowledge, you have no limiting physical conditions or disability that would preclude an exercise program.

    c. Medical Referal - As such, if you do have any limiting physical conditions or disabilities you have consulted with your GP and/or physio in regards to participation in this program, they are aware of it and have advised that participation is acceptable before any physical activity in this program begins. You also understand that I am not a doctor or physiotherapist and that any advice we offer outside of qualifications, though optimal, is NOT a replacement for professional advice from experts in that particular field. 

     

    2. My commitment to you:

    a. Confidentiality. All information you give us will be kept in confidence. Your personal details and medical information will not be made available to third parties unless permission to do so is granted by you. 

    b. Recommendations. Using our judgment and experience, we will suggest certain exercises and other lifestyle advice that we believe will help you achieve your personal goals, but if at any time you have specific requests please tell me so we can accommodate them.  Where we feel it's appropriate, we will advise that you seek professional advice from experts outside of qualifications and professional field. 

     

    3. Incomplete programmes/unused services/Terms/Conditions:

     •  Expiration policy requires all services be completed within the specified time frame of the proposed start date. Services are void after this period unless otherwise agreed to.

    3a. New member Terms and Conditions 

     * Minimum commitment period of 12 weeks.

    * Minimum 14 days notice for cancellation of services AFTER minimum commitment in line with program end.

    *Minimum 14 days notice for cancellations of Direct Debits AFTER minimum commitment in line with program end.

    *In the case of medical circumstances related to health or injury, a doctors certificate is to be provided in order to cancel your services

     

    4. Testimonial/photo release:

    a. You hereby RELEASE, WAIVE and FOREVER DISCHARGE any and all claims arising out of, or in connection with, such use by us, including without limitation any and all claims for libel or invasion or privacy.

    b. You hereby RELEASE, WAIVE and FOREVER DISCHARGE any and all claims arising out of, or in connection with, such use by us, including without limitation any and all claims for libel or invasion or privacy.

     

    5. Results:

    You understand the results of any training programme or coaching course are a combination of exercise, nutrition, adherence to the programme and genetics.  Your progress depends on your effort and cooperation in and outside of the program.

     

    6. Sessions:

    It is your responsibility to inform us of any symptoms such as fatigue, shortness of breath or chest discomfort. You also agree that we may also terminate a particular exercise or workout at any time if I believe you are not in suitable condition for that exercise.

     

    8. Payment:

    We on a direct debit basis for all of services. Payments are taken weekly from your nominated account/card and where payments may become overdue, the program may be frozen until up to date. Late payments will also incure a late fee of up to $20 per failed transaction.  

     

  • 9. Confirmation

  • By signing below you agree to all of the subject matter stated here and above. You confirm that you are of at least 18 years of age and have the right to agree to all of the above and that all of the information you have given is correct to the best of your knowledge. If below 18 years of age, a Parent/Guardian has read these terms and agree to them on your behalf. 

    *If under the age of 16- your parent/guardian will sign below*

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