Online Classes Booking/Payment/Screening

Get Fit with Siofra Online Classes

Please book accordingly.
Name

First NameLast Name
Email Address
example@example.com
Get Fit With Siofra - Monday, Wednesday, Friday - 7:00am

Classes include a combination of Upper & lower body exercises to strengthen and tone Arms, Legs, Bums & Tums

Types of Classes: Hiit/tabata, Step, Legs,bums & Tums, Kettlebell, Circuits, core strength & Conditioning and kickboxing.

I will help you boost your energy levels, & feel your best at anytime of the day.

Workouts all saved to do at a time to suit your busy schedule.

Equipment used - Booty bands, Handweights, Kettlebells and optional step/skipping rope.

All fitness levels are catered for, Beginner-advanced options are demonstrated throughout each class.
Appointment
If you can no longer attend the class, please cancel with as much notice as possible.
Please remember to logon up to 10 minutes before the class starts.
Payment options
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4 week challenge subscription
4 week challenge including 3x classes a week.

€30.00 for each month
Screening & Informed Consent Form

The information contained in this form is totally confidential and is only used to prescribe a safe and effective training programme for you.
New clients and returning customers with any medical changes please complete.

Please read through each and every item in this informed consent and mark each checkbox provided as an affirmation to the understanding of the provisions below.

Fitness Trainer: Siofra O Connor
Name

First NameLast Name
Date of birth

MonthDayYear
Date
Email
Phone number
Please enter a valid phone number.Format: (000) 000-0000.
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Emergency contact name & number
Doctors name & number
Please answer the following questions by ticking the correct responses.
Do you have any heart problems?
Is there a history of heart disease/stroke in your family?
Have you ever experienced any pain or discomfort in your chest whilst exercising?
Do you suffer from high blood pressure?
Do you suffer from any illness or disease? If yes, please specify:
Are you currently on any medication? If yes, please specify:
Do you have any type of muscle, joint or back problems? If yes, please specify:
Have you had any surgery within the last 4 months?
Are you pregnant or have been in the last 4 months?
Do you have a hernia or any other condition that may be aggravated by lifting weights?
Do you have a hernia or any other condition that may be aggravated by lifting weights?
Have you ever been advised by a doctor not to exercise?
Do you smoke? If yes, how many a day?
What type of exercise do you currently do and how often?
Informed consent:
I First Name Last Namedeclare that I intend to take part in the fitness class offered by Siofra O Connor. I am aware that as with all types of exercise, there is an inherent risk of heart attack, light-headedness, fainting, cramps, muscle or joint injury etc. I acknowledge that my choice to participate in this fitness class brings with it the assumption by me of those risks, and I understand that I am free to withdraw from this programme or modify my activity levels at any time. I assume full responsibility during and after my participation to use or apply at my own risk any portion of the information or instruction I receive. I understand that Siofra O Connor accepts no responsibility whatsoever for any injuries or death during or after participation in the fitness class.
COVID -19 By signing this agreement, I acknowledge the contagious nature of COVID-19 & voluntarily assume the risk that I may be exposed to or infected by COVID-19 by attending Siofra O Connors Fitness Classes or Personal Training & that such exposure or infection may result in personal injury, illness, permanent disability, & death. I understand that the risk of becoming exposed to or infected by COVID-19 at Siofra O Connors Fitness Classes or Personal Training may result from the actions, omissions, or negligence of myself and others, including, but not limited to, Siofra O Connor, volunteers, & programme participants & their families. I voluntarily agree to assume all of the foregoing risks & accept sole responsibility for any injury to my myself (including, but not limited to, personal injury, disability, and death), illness,
damage, loss, claim, liability, or expense, of any kind, that I may experience or incur in connection with my attendance at Siofra O Connors Fitness Classes or Personal Training. On my behalf, & on behalf of my children, I hereby release, covenant not to sue, discharge, & hold harmless Siofra O Connor, of & from the Claims, including all liabilities, claims, actions, damages, costs or expenses of any kind arising out of or relating thereto. I understand & agree that this release includes any Claims based on the actions, omissions, or negligence of Siofra O Connor, whether a COVID-19
infection occurs before, during, or after participation in any Siofra O Connors Fitness Classes or Personal Training.
Participant signature
Date

MonthDayYear
Date
Witness signature
Date

MonthDayYear
Date
Thank you for completing this form. I'm so excited to welcome you to my classes! Please check your emails for access to the Facebook group.

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Get Fit with Siofra Online Classes

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Screening & Informed Consent Form

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