• CLARITY COACHING

    Sign-Up Form

  • Person Information

    General
  • Date Of Birth*
     - -
    2 digit month, 2 digit day, 4 digit year

  • Person Information

    Par-Q
  • Has a doctor or healthcare professional ever told you that you have a heart condition, high blood pressure, or another medical condition that could affect your ability to exercise safely?*
  • Do you currently experience, or have you recently experienced, chest pain, dizziness, fainting, unusual shortness of breath, heart palpitations, or unexplained fatigue during rest or physical activity?*
  • Do you have any current or previous injuries, pain, joint/muscle problems, surgeries, or physical limitations that could be aggravated by exercise or require your training to be modified?*
  • Are you currently taking any medication, receiving medical treatment, pregnant/recently postpartum, or managing any health condition that may affect your ability to exercise safely?*
  • Is there any other health concern, medical advice, symptom, or reason not already mentioned that means you should seek medical guidance before beginning or increasing your exercise programme?*

  • Personal Information

    Lifestyle
  • Do you smoke?*
  • Do you drink?*
  • How active are you?*

  • Extra Information

    Goals, Exseperince, Needs, Etc
  • How experienced are you in a gym setting?*
  • Pick the service you have chosen*

  • Informed Consent

  • Informed Consent for Personal Training, Online Coaching and small group personal training/coaching

    I'm excited to work with you to help you achieve your fitness goals. This form explains the nature of our coaching relationship, potential risks, and your responsibilities. Please read it carefully and let me know if you have any questions before signing.

    1. Nature of the Service:

    As your coach, I will provide guidance and support to help you reach your fitness goals. This may include:

    * Developing personalized workout plans
    * Providing nutritional guidance and meal suggestions
    * Offering support and motivation
    * Tracking your progress and making adjustments as needed

    2. Qualifications:

    I hold the following certifications and qualifications: Level 2 YMCA GYM Instructor, Level 3 YMCA Personal Trainer, Level 3 Fitness Services

    3. Potential Risks:

    Physical activity carries inherent risks, regardless of how carefully you follow instructions. These risks include, but are not limited to:

    * Muscle strains and sprains
    * Joint pain
    * Cardiovascular events (e.g., chest pain, dizziness)
    * Injuries from improper form or technique

    4. Client Responsibilities:

    Your success depends on your commitment and honesty. You agree to:

    * Disclose any pre-existing medical conditions or injuries
    * Follow the workout and nutrition plans to the best of your ability
    * Communicate any pain or discomfort immediately
    * Obtain clearance from your physician before starting any new exercise program

    5. Confidentiality:

    I will keep your personal information and progress confidential, except as required by law.

    6. Cancellation Policy:

    More than 24 hours notice (No charge)

    Less than 24-12 hours notice (50% of the full session)

    Less than 12 hours notice (Full session charge)

    7. Disclaimer:

    I am not a medical professional. The advice and guidance I provide are not intended to be a substitute for professional medical advice. Always consult with your physician before making any changes to your diet or exercise routine.

    8. Agreement:

    By signing below, you acknowledge that you have read and understand this informed consent form, and you agree to participate in personal training and online coaching services with Preston Tipple or Clarity Coaching under the terms outlined above.

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  • Date of signature*
     - -
    2 digit month, 2 digit day, 4 digit year
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