• North Labs: Client Information, Health History, Waiver & Release

  • Instructions

  • This is your comprehensive client intake package. Please complete this form after you have completed the PAR-Q+ (Physical Activity Readiness Questionnaire). Your answers are essential to designing a safe, individualized program. Please answer as accurately and completely as possible.

  • Disclaimer

  • It is your responsibility to consult with your physician before, during, and after participating in this fitness program. Information provided by North Labs is not a substitute for medical advice and should not be followed without your physician's approval. If you choose to proceed without physician consent, you accept full responsibility for that decision.
  • Nutrition Guidance Disclaimer (If Selected)

  • If you elect to add the optional Nutrition Guidance Add-On to your coaching plan, you acknowledge that this guidance including any general calorie or macronutrient targets provided is goal-based and educational in nature, and does not constitute medical nutrition therapy, a clinical nutrition service, or a substitute for advice from a Registered Dietitian or physician. If you have a diagnosed medical, metabolic, or nutritional condition including but not limited to diabetes, gastrointestinal disorders, or a history of disordered eating you should consult a Registered Dietitian or physician before making dietary changes, and should disclose such conditions to Coach so that an appropriate referral can be made.

  • Client Information

  • Date (mm/dd/yyyy):*
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  • Format: (000) 000-0000.
  • DOB (mm/dd/yyyy):*
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  • PAR-Q+ Confirmation

  • If any question on the PAR-Q+ was answered "yes," I understand North Labs may require written clearance from a physician before beginning or continuing a program
  • Confidentiality Acknowledgment

  • I understand that the information collected by North Labs will be used for fitness evaluation purposes and for the design, implementation, progression, and maintenance of an individualized fitness program only. I understand that all such information is confidential and will not be shared with anyone without my prior written authorization, except in the case of a medical emergency or to the minimum extent necessary to achieve a safe and effective fitness program.

  • North Labs retains client health information only for as long as necessary to provide services, and in accordance with applicable Canadian privacy law (PIPEDA). Records are stored securely and are not shared with third parties without consent.
  • By signing below, you acknowledge and agree to the confidentiality terms above.
  • Date:*
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  • Assumption of Risk, Waiver and Release of Liability

  • I give my consent to participate in the physical fitness evaluation and training program conducted by North Labs, delivered remotely/online unless otherwise agreed in writing,
  • Benefits:
    Participation in a regular program of physical activity has been shown to produce positive changes in a number of organ systems, including increased work capacity, improved cardiovascular efficiency, and increased muscular strength, flexibility, power and endurance.
  • Risks:
    I recognize that exercise carries some risk to the musculoskeletal system (sprains, strains) and the cardiorespiratory system (dizziness, discomfort in breathing, heart attack). I certify that I know of no medical problem, except those noted on this form and on the accompanying PAR-Q+, that would increase my risk of illness or injury as a result of participation in a regular exercise program.
  • Online/Virtual Training Acknowledgment:

  • I understand that North Labs coaching is delivered remotely, without a trainer physically present to correct my form or supervise my environment in real time. I acknowledge that I am solely responsible for: (a) selecting a safe, adequately spaced, and appropriately equipped location in which to exercise; (b) the condition, maintenance, and safe use of any equipment I use, whether owned by me or a third-party facility; (c) stopping any exercise immediately if I experience pain, dizziness, or discomfort; and (d) accurately following written and video instructions provided by North Labs. I understand that North Labs cannot observe my form or environment in real time except during scheduled video check-ins, if any.
  • Testing and Evaluations:

  • I understand that I will undergo occasional fitness assessments to determine my current physical fitness status, used by North Labs to inform my individualized program. My results will be made available only to me, and I may share them with anyone I choose, including my personal physician. I understand this testing does not replace medical testing or the services of a physician. By signing this form, I understand I am personally responsible for my actions while working with North Labs, and I waive North Labs' responsibility for any injury resulting from my own negligence.
  • Media & Testimonial Consent (optional):

  • North Labs may wish to feature client progress, results, or testimonials in its marketing (e.g, social media, website). This is entirely optional and separate from your fitness program enrollment.*
  • I understand I may revoke this consent at any time by written notice to North Labs, though content already published prior to revocation may remain in circulation.
  • Release:

  • On behalf of yourself and your personal representatives, heirs, executors, administrators, agents, and assigns, you agree to release and discharge North Labs (and its affiliates, employees, agents, representatives, successors, and assigns) from any and all claims or causes of action, known or unknown, arising out of the negligence of North Labs, whether active or passive. This release includes, without limitation, injuries arising from: (a) your use of any exercise equipment, whether at your home, a third-party facility, or elsewhere, which may malfunction or be improperly maintained; (b) instruction or programming provided remotely by North Labs; (c) your own environment, space, or equipment selection; and (d) any injury sustained while following a North Labs program without direct in-person supervision. You acknowledge that you have carefully read this waiver and release and fully understand that it is a release of liability and an express assumption of risk. You are aware that by signing, you give up your right to bring a legal action or assert a claim against North Labs for North Labs' negligence. You confirm that no oral representations, statements, or inducements apart from this written agreement have been made to you.
  • Governing Law:

  • This agreement is governed by the laws of the Province of Ontario and the federal laws of Canada applicable therein, without regard to conflict of law principles. If you reside outside Ontario, you agree Ontario courts have jurisdiction over any dispute arising from this agreement.
  • Minors:

  • North Labs does not currently accept clients under the age of 18. If this changes, a parent or legal guardian's signature will be required in addition to this form.
  • Privacy Policy Acknowledgment:

  • North Labs collects and uses your personal information in accordance with our Privacy Policy, available at North Labs Privacy Policy. By checking the box below, you confirm that you have read and agree to the terms of the Privacy Policy.

  • By signing below, you acknowledge you have read, understood, and voluntarily agree to the Assumption of Risk, Waiver, and Release of Liability set out above.
  • Date:*
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