THE ATHLETE WITHIN

First name

Last name

3 personal descriptors (occupation - hobbies - big fan of) eg. Banking advisor, love island enthusiast, dog lover)

Your fitness or health goal(s). Be as specific as possible!

What are the top 3 things you perceive as getting in your way from achieving the goals you identified?

Tell me a little bit about your history with health and fitness up to this point.

What kind of assistance would you be looking for to help you achieve your health and fitness goals?

What are your goals outside of health and fitness?

How did you hear about us?

Referral

Social Media

Other

If Referral - please leave their name below!

DROP IN DATE MONDAY

DROP IN DATE WEDNESDAY

DROP IN DATE FRIDAY

Emergency Contact Full Name

Emergency Contact Phone Number

Relationship to Athlete

I have read, understood, and agree to the Waiver, including the assumption of risk and release of liability.

I consent to photos, videos, testimonials, and audio recordings taken in connection with my participation being used by Coach for marketing and promotional purposes, with or without my name, without further notice or compensation.

I acknowledge that I have read this waiver in it's entirety and agree to the terms listed. This is your signature of agreement

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Fixed price

CA$45