Storm Personal Training operates a safe and reliable policy

Please complete and submit the form below if you are signing up for an online training programme.

If you are meeting your fitness coach for an initial consultation or for your first session, please print out the form, complete it, sign it and bring it with you. Please read the terms and conditions laid out below. If you are exercising during or after pregnancy, you will be required to complete some further questions in addition to the ones below which will be emailed to you once you have submitted this form.

Your full name

* required

Your date of birth

* required

Address

* required

Postcode

* required

Mobile number

* required

Email address

* required

Please indicate the best way to contact you

Please answer the following questions

1. Has your doctor ever said you have heart trouble?

2. Have you ever had pains in your chest?

3. Do you often feel faint or have spells of dizziness?

4. Has a doctor said your blood pressure is too high?

5. Has a doctor said that you might have bone or joint problems, such as arthritis, that has been aggravated by exercise or might be made worse with exercise?

6. Have you been in hospital in the last 3 years?

7. Are you currently taking any medication?

8. If 'Yes' what medication do you take?

9. Are you Pre/Post natal?

10. Do you suffer from asthma, or breathing difficulties?

11. Do you suffer from diabetes or epilepsy?

12. Do you suffer from an allergy?

13. Is there a good physical reason not mentioned here why you should not follow an activity programme?

If you have answered 'Yes' to one or more questions
If you have not recently done so, consult with your doctor before increasing your physical activity and tell your doctor which questions you answered yes to.

If in any doubt, seek your doctor's advice as to your suitability for unrestricted physical activity that progresses gradually.

How would you describe your current level of fitness?

Very fit

Fit

Average

Unfit

Signature (not required for online training programmes)

I agree to the terms and conditions

By completing the form and submitting it online, or by filling in the form and submitting it with your signature, you are agreeing to the terms and conditions laid out below.

In consideration of being allowed to participate in the activities and programmes of Storm Personal Training and to use the facilities and equipment owned and/or under the control of Storm Personal Training, in addition to the payment of any fee or charge, I do hereby waive, release and forever discharge Storm Personal Training from any and all responsibility or liability for injuries or damages resulting from my participation in any activities or my use of equipment or facilities in the above mentioned activities.

I understand and I am aware that strength, flexibility and aerobic exercise, including the use of equipment, in the outdoors, are potentially hazardous activities. I also understand that exercise and fitness activities involve a risk of injury and even death, and that I am voluntarily participating in these activities and using equipment and facilities with the knowledge of the dangers involved.

I hereby agree to expressly assume and accept all and any risks of injury or death. I am aware that I have the right to request advice from any of the Storm Personal Training staff, at any time, in relation to the activities and exercise being undertaken and, but not exclusively, their suitability for me, with particular regard to my health and clothing. If I choose not to take advice, or to disregard any advice so given, I do so voluntarily and accept liability for all resulting injuries or damage.

I do hereby declare myself to be physically sound and suffering from no condition, impairment, disease or infirmity or other illness (other than those declared on the attached medical questionnaire) that would prevent my participation or use of equipment or facilities except as herein stated.

I acknowledge that I have either had a physical examination and have been given my doctor’s permission to participate, or that I have decided to participate in activity and use of equipment and machinery without the approval of my doctor and do hereby assume all responsibility for my participation and activities, and utilisation of equipment and machinery in my activities. In addition, Storm Personal Training cannot accept responsibility for valuables left in instructor’s vehicles.

Exercise can significantly reduce a lot of the symptoms suffered by people with MS, Parkinson's, diabetes, asthma, high blood pressure and other stress-related issues. Good communication with your fitness coach is essential throughout your training programme to ensure that you work through the training safely and effectively. For more details about how exercise can benefit you, email sarah@stormpersonaltraining.com today.