Personal Training - Informed consent Full Name Email Adresss Mobile phone number Date of birth Emergency Contact name Emergency Contact Phone Number Do you have any of the following conditions? Heart Condition Pregnant or given birth within last 9 months Circulatory condition Joint problems Hypermobility Rheumatic or osteoarthritic conditions Neurological conditions Asthma High Blood Pressure Low Blood Pressure Pacemaker or Dizziness Screws or Plates Diabetes Bronchitis Injuries such as broken bones, torn ligaments or damaged tendons Epilepsy or seizures Any other medial conditions that may affect you ability to safely take part in any exercise programme NONE Further informationParticipation is at your own risk. If you replied YES to any of the above, we advise that you take appropriate medical advice from a medical professional and provide a doctors note before you attend a PT session. Should you decide not to follow this advice, you do so at your own risk and therefore take full responsibility for any illness or injury resulting from participation in a session. You are advised to listen to your body and take it at your own pace during the sessions. You will be made aware of the exercises in advance and you can choose not to participate if you have any health issues, injuries or illnesses. If you have answered YES to any of the above, please provide additional information Medical Conditions I have declared any medical conditions/injuries Personal training objectives & risk I understand that the purpose of Personal training is to provide safe exercise to improve health and fitness and to meet my own, personal goals. Exercises may include: Cardiovascular activities such as walking/jogging/running/side-stepping/aerobic/dance/jumping/rebounding and other similar activities; body-weight exercises and activities involving equipment such as resistance bands, weights, kettlebells, boxing equipment, exercise bike and rebounders. Session Participation By entering into this Agreement you agree that, if you experience any discomfort or pain during a PT session, you will stop participating immediately and inform the Personal Trainer and take appropriate medical advice from a medical professional. Revive Fitness Personal Trainers are not medical professionals or medically trained and cannot offer you any medical advice. Allergies to dogs PT sessions are currently held in our studio in our home, where a short-haired dog is present. While our dog will not have access to the studio during training times, we are conscious that some people may have allergies to dogs. Please let us know if you are affected as we may need to conduct training elsewhere, if possible. I DO NOT have any allergies to dogs I DO have a dog allergy Photos & Video I understand the pictures or videos of the session maybe recorded and used in marketing or to assess safety of client, such as highlighting issues with form, or to demonstrate a client's progress. Pictures and videos will not be shared without your consent. Declaration By completing this declaration I confirm that I have read and understood the above information. The information obtained will be treated as private and confidential. Agreement I understand and accept the terms of this agreement. Agreement’ means this ‘Revive Fitness Client Agreement’, which contains the terms upon which you engage in. ‘Session’ means any scheduled session or period of time spent undertaking or discussing Personal Training, physical activities and/or exercise and/or training with, and/or under the direction of, Revive Fitness Classes. 'Emergency Contact’ means a person, who is likely to be contactable and available whilst you are attending a session, whom your Revive Fitness Personal Trainor can contact in the event of an emergency. 'Personal Trainor’ means a representative of Revive Fitness Classes who will host and direct your Session. 'We’ or ‘Our’ means Revive Fitness Classes. Information we collect: We require your full name, address, phone number, email, date of birth and details of any medical conditions. We also require the name and phone number of an emergency contact. This information is required so that we can contact you if your PT session is cancelled, rescheduled or otherwise changed. Medical information is for insurance purposes and so that we can ensure your training is suitable. Under the GDPR, we do not share that information with any one else. We cannot and do not use this information for any other purpose other than stated. You will not receive any marketing or promotional information from us, unless you explicitly sign up to do so. Send
