Step 1: Physical Activity Readiness Questionnaire

(PAR-Q) 

 

This questionnaire is designed to help me learn what I need to know to help you stay safe and healthy during exercise while reaching your goals. The form is broken into 3 sections and may take between 5-7 minutes to complete. Please take your time and fill out this questionnaire as honestly as possible.

 

About You

Please answer the questions below by checking YES or NO.

If you checked box 1 or 3, please sign the release below.

If you checked box 2 or 4, I highly recommend getting clearance from your healthcare provid- er before starting an exercise program. Please ask them to provide a signed clearance form and give it to me, along with this PAR-Q form.

Disclaimer and Release

• I, the undersigned, have read, understood to my full satisfaction, and completed this questionnaire.
• I understand that if my health changes, I must inform my coach and check with my GP or PCP that I’m still cleared for exercise.
• I recognize that it is my responsibility to work directly with my GP or PCP before, during, and after seeking fitness and/or nutrition consultation.
• I understand that any information provided is not to be followed without prior approval of my GP or PCP. If I choose to use this information without such approval, I agree to accept full respon- sibility for my decision.
• I acknowledge that my coach may retain a copy of this form for their records. In these instances, they will maintain the confidentiality of the same, complying with applicable law

Step 2: Cancellation and Refund Policy

 

LATE / NO-SHOW / CANCELLATION AGREEMENT

Our main goal is to provide the best possible service to our clients. Untitled Fitness Train Hybrid and in-person training works partially on an appointment based schedule to allow you the time required for your personal training session. Sessions will generally be 60 minutes. Please be on time for your appointments. If you are late for a session it will still end at the scheduled time. If you are more than 15 minutes late for a session, it will be considered a no-show and you will be required to pay the fee for the session.

 

Due to this schedule it is important that you give us sufficient notice when you need to cancel an appointment. This means a cancellation should be made at least 12 hours before the scheduled appointment. Failure to cancel a training session within this time will result in you losing the session without replacement. Should you wish to reschedule an appointment, a minimum of 12 hours notice is required.

 

We will do our best to accommodate this. We understand that emergencies happen. We provide every client with one free short-notice cancellation. You will not be charged for your first cancellation with less than 12 hour notice. Subsequent short-notice cancellations will be a loss in your agreed package of sessions. The free short-notice cancellation only applies if we are notified prior to the session start time. No-shows are not eligible for the free cancellation. I have read the above policy and agree to its terms as it applies to my personal training package.

REFUND AGREEMENT

Our main goal is to provide the best possible service to our clients. You have a legal right to change your mind about making a purchase from us within 14 days and receive a refund. These rights are under the Consumer Contracts Regulations 2013. If you are not satisfied with our services, we will be happy to refund services not performed. I have read the above policy and agree to its terms.

 

PAYMENT AGREEMENT

In-person / virtual sessions will be pre-paid in advance through online billing, with either stripe, paypal or gocardless payment links attached to the digital invoice. I have read the above policy and agree to its terms.

 

Step 3: Informed Consent*

Part 1: Untitled Fitness Waiver

Programme objectives and procedures

I understand that the purpose of the exercise programme is designed to provide safe and individualised exercise to improve my health and fitness. My activity plan may include:

●  Cardiovascular training activities - using cardio machines; rowing, upright or recumbent cycling, treadmill, elliptical, stair climbing and other such activities. Using bodyweight; running, skipping and other such activities.

●  Resistance training activities - using resistance machines, free weights or body weight to improve muscular strength and endurance.

●  Warm up, cool down and flexibility exercises to improve range of motion and joint health.

 

Potential Risks

The exercise program is designed to gradually increase in intensity and will challenge the cardiovascular and muscular systems in order to improve their function. Adaptation and reactions to exercise cannot always be predicted with complete accuracy. There is a risk of certain changes that may occur during or following exercise. I accept sole responsibility for any injury that I may sustain in participating in physical activity during personal training and understand that Sheldon Michelle Amosu (Untitled Fitness) may in no way be responsible. I have read, understood and honestly answered the questions on the PAR-Q.

I wish to participate in physical activities that may include aerobic exercise, anaerobic exercise, resistance exercise and flexibility exercises. I realise that in participating in these activities I may be at risk of injury and even the possibility of death.

 

Potential Benefits

I understand that regular exercise has been shown to provide several benefits that improve quality of life. Some of these benefits include:
●  Improved Blood Pressure
●  Improved Cardiovascular Fitness
●  Improved Muscular Strength
●  Improvef Mobility and Flexibility 
●  A decrease of risk of heart disease
●  Improvement of physiological function and daily physical activities.

The exercise program has been explained to me and my questions regarding the programme have been answered to my satisfaction. My information obtained will be treated as private and confidential. I have provided a doctor’s note if I checked YES to the 8 initial questions in the PAR-Q. My signature on this form releases Sheldon Michelle Amosu (Untitled Fitness) from any and all liability and claims relating to any possible injuries sustained as a result of my participation. I can confirm that I am participating voluntarily.

Part 2: Covid-19 Liability Waiver

If you attend classes or participate in personal training at Untitled Fitness, you agree to the following additional provisions of the above liability waiver.

 

• I acknowledge the contagious nature of the Coronavirus/COVID-19 and public health authorities recommend practicing physical distancing.

 

• I further acknowledge that Untitled Fitness has put in place preventative measures to reduce the spread of the Coronavirus/COVID-19.

 

• I further acknowledge that Untitled Fitness cannot guarantee that I will not become infected with the Coronavirus/COVID-19.

 

• I understand that the risk of becoming exposed to and/or infected by the Coronavirus/COVID-19 may result from the actions, ommissions, or negligence of myself and others, including, but not limited to other family members and residents at the home gym. 

 

• I, voluntarily seek services provided by Untitled Fitness and acknowledge that I am increasing my risk of exposure to the Coronavirus/COVID-19. I acknowledge that I must comply with all set procedures to reduce the spread while attending any Untitled Fitness 1:1 sessions, classes and or training of any kind. 

 

I agree that I will only attend classes if:

• I am not experiencing any symptoms of illness such as a cough, shortness of breath or difficulty breathing, fever, chills, repeated shaking with chills, muscle pain, headache, sore throat, or new loss of taste or smell. 

 

• I have not travelled internationally within the last 14 days. 

 

• I do not believe I have been exposed to someone with a suspected and or confirmed case of the coronavirus/ COVID-19. 

 

• I am following all recommended guidelines as much as possible and limiting my exposure to the coronavirus/COVID-19. 

 

• I release and agree to hold Untitled Fitness harmless from, and waive on behalf of myself, my heirs and any personal representatives any and all causes of action, claims, demands, damages, costs, expenses and compensation for damage or loss to myself and or property that may be caused by any act, or failure to act of Sheldon Michelle Amosu, or that may otherwise arise in any way in connection with any services recieved from Untitled Fitness. 

 

• I understand that this release discharges Untitled Fitness from any liability or claim that I, my heirs, or any personal representatives may have against Sheldon Michelle Amosu with respect to any bodily injury, illness, death, mediacal treatment, or property damage that may arise from or in connection to, any services recieved from Untitled Fitness.

Part 3: Untitled Fitness Public Relations Consent Form

 

Please read; For good and valuable consideration, and acknowledgement. I authorise Untitled Fitness  to use my name, likeness and testimonial (as depicted in social media, photographs or interviews either provided by me or taken or commissioned by Untitled Fitness as part of it's image and story bank is a collection of images and stories of Untitled Fitness clients intended to showcase their success in using Untitled Fitness products and or services.

 

Untitled Fitness may use the images and stories in the image and story bank, on its website (www.untitledfitness.com), as well as in various social media and promotional materials (including, among other things, publications, displays. pamphlets, and presentations) and potentially the media, without seeking my further consent in relation to any particular use. Untitled Fitness will not resell these images. Their use is intended solely for the purposes listed above.

 

I confirm that I am over 18 years of age and that I have not given anyone rights to use my name, likeness and testimonial that would interfere with their use by Untitled Fitness. I understand that my name, likeness and success story will be included in the image and story bank for an indefinite period of time. Should I wish to have my name, likeness or testimonial removed from the image and story bank, I will ask Untitled Fitness to do so by contacting its customer service team at untitledfitness.pt@gmail.com. I hereby consent to the collection, use, and disclosure of my personal information for the purposes of the image and story bank for use with the media.

 

Part 4: Photos & Videos

 

I give Untitled Fitness the express permission to take and use photos and videos of likeness. I acknowledge that I will have no claim against Untitled Fitness, its affiliates, or any of their respective officers, directors, or employees who accesses or uses images from the image and story bank, in relation to the use of the images as set out above.