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PAR-Q & Client agreement
PAR-Q & Client agreement
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Description
About you
First name
*
Last name
*
Email address
*
Phone
*
Date of birth
*
Day
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Street Address
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Country
Afghanistan
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Christmas Island
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Congo, Republic of the
Cook Islands
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French Guiana
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Guyana
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Heard Island And Mcdonald Island
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Hungary
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India
Indonesia
Iran
Iraq
Ireland
Israel
Italy
Jamaica
Japan
Jersey
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Jordan
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Kenya
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Korea, Republic of
Kosovo
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Lao People's Democratic Republic
Latvia
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Lesotho
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Libya
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Lithuania
Luxembourg
Macau
North Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montserrat
Montenegro
Morocco
Mozambique
Myanmar
Namibia
Nauru
Nepal
Netherlands
Netherlands Antilles
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
Northern Mariana Islands
Norway
Oman
Pakistan
Palau
Palestine, State of
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn Islands
Poland
Portugal
Puerto Rico
Qatar
Reunion Island
Romania
Russia
Rwanda
Saint Kitts and Nevis
Saint Lucia
Saint Vincent and the Grenadines
Samoa
Saint Helena
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Serbia
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Singapore
Sint Maarten
Slovakia
Slovenia
Solomon Islands
Somalia
South Africa
South Georgia and South Sandwich
Spain
Sri Lanka
Stateless Persons
Sudan
Sudan, South
Suriname
Svalbard and Jan Mayen
Swaziland
Sweden
Switzerland
Syria
Taiwan, Republic of China
Tajikistan
Tanzania
Thailand
Togo
Tokelau
Tonga
Trinidad and Tobago
Tunisia
Turkey
Turkmenistan
Turks And Caicos Islands
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
US Minor Outlying Islands
United States of America (USA)
Uruguay
Uzbekistan
Vanuatu
Vatican City
Venezuela
Vietnam
Virgin Islands, British
Virgin Islands, U.S.
Wallis And Futuna Islands
Western Sahara
Yemen Arab Rep.
Yemen Democratic
Zambia
Zimbabwe
Lifestyle
Occupation
*
How Active Is Your Job?
*
Select one...
Extremely
Very
Quite
Not at all
Health history
Age
*
Height (in metres)
*
Weight (in kg)
*
Are you pregnant?
*
Yes
No
Have you had a baby in the last 6 months?
*
Yes
No
If yes, how long ago?
Are you breastfeeding?
*
Yes
No
Did you have any complications with your pregnancy or after birth, such as a prolapse or separation of stomach wall (Diastasis Recti)
Please also include what type of birth you had - natural/C-section
Do you have high, low or normal Blood Pressure?
*
Please expand
Do you have high, low or normal Cholesterol?
*
Please expand
Have you had any surgery recently? If yes what for?
*
Do you have any injuries that would prevent you from certain exercises (such as high impact exercises)
*
Have you ever had an eating disorder?
*
Are you currently taking any medication? If yes, what is it and what are you taking for?
*
What are your goals?
*
Terms and conditions
By checking this box, I agree to the terms set forward of ace 12 week transformation Programme and agree to all the terms laid out in the Terms and Conditions for this Programme.
Physical Activity Readiness Questionnaire (PAR-Q)
If you are between the ages of 15 and 69, the PAR-Q will tell you if you should check with your doctor before you significantly change your physical activity patterns. If you are over 69 years of age and are not used to being very active, check with your doctor. Common sense is your best guide when answering these questions please read carefully and answer each one honestly: check YES or NO.
Has your doctor ever said you have a heart condition and that you should only do physical activity recommended by a doctor?
*
Yes
No
Do you feel pain in your chest when you do physical activity?
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Yes
No
In the past month, have you had a chest pain when you were not doing physical activity?
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Yes
No
Do you lose your balance because of dizziness or do you ever lose consciousness?
*
Yes
No
Do you have a bone or joint problem (for example, back, knee, or hip) that could be made worse by a change in your physical activity?
*
Yes
No
Is your doctor currently prescribing medication? (for your blood pressure, heart condition etc?)
*
Yes
No
Do you suffer from Asthma?
*
Yes
No
Do you suffer from Epilepsy?
*
Yes
No
Do you know of any other reason why you should not do physical activity?
*
Yes
No
If yes, please comment:
Signed
*
In consideration of being able to take part in exercise and physical activity organised by ace lifestyle, I acknowledge that I am physically fit for participating in ace lifestyle activities. I agree to abide by all verbal and written notices regarding safety whilst exercising with ace lifestyle. ace lifestyle shall not be liable for any injury or death I may suffer in these activities.
Full name
*
Personal Training - Client agreement
24 Hour notice
*
I, the client, agree to give 24 hours notice for cancellation of sessions. I understand that if 24 hours notice is not given, the fee for that session will stand. With group session, it is the responsibility of all participants to cover the cost of the session in full if 1 participant cancels within 24 hours.
24 Hour notice
*
If a session is cancelled by trainer, a make-up session will be made available to the client.
Make up Sessions
*
I, the trainer, agree that upon cancellation of a session, by trainer, a make-up session will be made available to the client.
Credit for missed session
*
I, the client understand that if I receive credit for a missed session, the credit must be used within 60 days of the missed session, or it will be waived.
Late arrivals
*
I, the client, understand that if I am not on time for a session(s), the session(s) may be cut short and the full fee applied.
PT's late arrival
*
I, the trainer, understand that if I am not on time for sessions, the time will be made up at that session or a subsequent session.
Payments
*
I, the client, understand that failure to make payments within one month will result in the cancellation of the program.
Fitness
*
I, the client, understand that the outcome of any fitness program will be due to the work that the participants do, what the participants’ abilities are, and their genetic makeup. The factors outside of the personal training sessions are beyond the control of the trainer.
Rates
*
I, the client, understand that rates for ace Lifestyle are subject to change. Prepaid services by the client, which are unused at the time of rate change, will be honoured at the prepaid price.
Emergency
*
I, the client, understand that by signing this, I am also giving permission for the trainer to contact emergency services during an emergency situation if he or she sees fit.
Rules
*
I, the client, agree to observe any and all rules of the gym or facility where workouts take place, if applicable.
Injuries & limitations
*
I, the client, understand that I have control of the workout and may terminate a particular exercise or workout at any time. If a particular exercise is painful for you to do or you have an injury or other limitation that makes it difficult for you to do, your trainer can attempt to substitute another exercise to work that particular muscle group.
Workout session
*
I, the client, agree that the trainer can terminate a particular exercise or workout at any time if the trainer believes I am not in suitable condition for exercise—for example, if I, the client, am noticeably under the influence of drugs or alcohol, disclose the fact that I have abused drugs or alcohol medications or if I have not eaten anything in reasonable amount of time pre-workout, etc.
Signed
*
Full Name
*
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