BTYT Intake form

Better Than Yesterday Training – Client Intake & Participation Form

Please complete this form before beginning any training or wellness program with Better Than Yesterday Training.
SECTION 1

Basic Information
Name

First NameLast Name
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Email
example@example.com
Date of birth

MonthDayYear
Date
Emergency contact

First NameLast Name
Emergency contact phone number
Please enter a valid phone number.Format: (000) 000-0000.
SECTION 2

Goals & Experience
Primary fitness goal
Previous training experience
SECTION 3

Health Screening
Do you have any current injuries or limitations
Are you currently taking any medications that may affect physical activity?
I understand that Better Than Yesterday TrainingI acknowledge and agree provides fitness and wellness services only and does not offer medical advice, diagnosis, or treatment.
SECTION 4

Program Interest
Type a question
Section 5

Acknowledgment & Waiver
I voluntarily choose to participate in fitness and wellness activities provided by Better Than Yesterday Training. I understand that physical activity carries inherent risks and I assume full responsibility for my participation.
Section 6

Signature
Signature
Date

MonthDayYear
Date
Should be Empty:

Better Than Yesterday Training – Client Intake & Participation Form