TWF Intake

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Name* This field is required.
First Name
Last Name
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Email* This field is required.
example@example.com
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DOB* This field is required.
Date
Year
Month
Day
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Phone Number* This field is required.
Please enter a valid phone number.
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Gender* This field is required.
Male
Female
Non-binary
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Emergency Contact* This field is required.
First Name
Last Name
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Emergency Contact Phone Number* This field is required.
Please enter a valid phone number.
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Program Type* This field is required.Please choose the program you are wanting to complete:
Please Select
Please Select
Base (face to face)
Base (online)
Power (face to face)
Power (online)
Endurance (face to face)
Endurance (online)
Base (face to face) // 2 training day option
Power (face to face) 2 training day option
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Program Length* This field is required.
Please Select
Please Select
6 week block
12 week block
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Please specify what you are aiming to achieve from completing this program* This field is required.Ie. run 1/2 marathon, build overall body strength, improve 1RM etc ***Please note that if you indicate that your goal is to lose body fat, it is highly recommended that you choose to add on nutrition coaching. Nutrition advice, weigh ins, recipes and meal guides are not provided in the standard program.
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Ok
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If you are completing face to face OR online at FEF Gym, please select which time slot you are most likely to come along to
Please Select
Please Select
6:30am
7:45am
5:20pm
Open Gym
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Will you be opting to add on nutritional coaching?* This field is required.Please note that if you are seeking a body composition change from completing this program, it is highly advised to choose this add on. (ie weight loss, gain, body recomposition). This will either be provided in the form of weekly meal guide templates, calorie counting or a combined approach over your training block.
YESNO
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Payment Option* This field is required.
Upfront
Direct Debit
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Do you have any injuries/conditions (past or current) that may inhibit you from completing some exercises?* This field is required.
YESNO
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If yes, please explain below* This field is required.
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Do you have the go ahead from your GP to get back into exercise?* This field is required.If not, this is mandatory before starting the program
YESNO
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Have you been told that there are any movements/exercises that you should not be completing at this point in time?* This field is required.
YESNO
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If yes, please explain below
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Program goal
Lose body fat
Maintain
Build muscle
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Have you tracked your calories before?
YESNO
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Which of the following options are you looking to use when it comes to nutrition coaching
Tracking calories and macros
Meal guides/templates
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Do you follow any of the following eating patterns
Vegan
Vegetarian
Pescatarian
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Do you have any allergies/intolerances/foods you dislike and will not eat?
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Please tick if any of the following applies to you
Eating Disorder (binge eating, bulimia, restricting)
Endometriosis/PCOS
Gastrointestinal surgeries (in the last 12 months)
Diabetes
Pregnant/lactating
Heart Issues
Other
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If you ticked any of the above, please explain
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Are you smoker?
YESNO
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Average hours of sleep per night?
Under 5 hours
5-6 hours
6-7 hours
7-8 hours
8+ hours
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How active are you?(Outside of the gym)
Lightly active- spend a good part of your day standing / on your feet (ie hospo work)
Heavily active- spend most of the day doing heavy physical activity (ie labourer)
Sedentary- spend most of the day seated (ie office work)
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How many steps do you currently get in a day? (on average)
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Do you drink alcohol?
YESNO
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If you answered yes to the question above, how many standard drinks do you have per week?
1-4
4-8
8-10
10+
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How many serves of fruit and veg do you eat per day?
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Four Element Fitness ("FEF") accepts no responsibility form, and you release FEF from any claim relating to, personal injury or loss of life incurred or suffered as a result of a program of phyhsical exercise (program). In the event that you attend a program with a minor, the minor in attendance must be supervised. FEF accepts no responsibility for the supervision of minors. FEF further disclaims any liability for, and you release FEF from any claim relating to, personal injury or loss of life incurred or suffered by minors.

All denials of responsibility by FEF, and releases and indemnities provided by you under this agreement, only apply to the extent that they do not exclude, restrict or modify, or have the effect of excluding, restricting or modifying:

the application of all or any of the provisions of the Part 3-2, Division 1 of the Schedule 2 of the Competition oand Consumer Act 200 (Cth) (the Act); or
the exercise of a right conferred by such a provision; or
any liability of a person for a failure to comply with a guarantee that applies under the Act to a supply of goods or services.

Injury
I understand that if I am injured in the duration of the 6 week program and no longer able to train, that I am still able to commit to the nutrition the program offers. I understand that I must provide a medical certificate from a health professional stating that I cannot train for the rest of the duration of the program. Once FEF has recieved your certificate, you will be credited for the remaining of the program that you will miss. This will be credited in the form of a program certificate which cannot be transferred or refunded. At no point once the program commences will you be refunded any money from your participating program.

Pregnancy
I understand that if I fall pregnant in the duration of the 6 week program, I will no longer be able to receive dietary advice from FEF. I am still able to commit to the training that the program has to offer. I understand that i must provide a medical certificate from a health professional stating that I can still train for the rest of the duration of the program. Once FEF has received your certificate, if you are following nutritional coaching, you will be credited for the coaching you will miss at a value of $100. If you are not cleared for training form a fitness profressional then I understand that I must provide a medical certificate from a health professional stating that I cannot train for the rest of the duration of the program. Once FEF has recieved your certificate, you will be credited for the remaining of the program that you will miss. This will be credited in the form of a program certificate which cannot be transferred or refunded. At no point once the program commences will you be refunded any money from your participating program.

By clicking "Submit" you have read and agree with the above T&C's
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ORDER SUMMARY
Total costAUD
DepositThis $100 deposit is required to secure your spot in the TWF Program. The deposit will come off of your total program price. It is important to note that the deposit is non-refundable, non-transferable and non-exchangeable
$100.00AUDEdit
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