• Date Format: DD slash MM slash YYYY
  • Program Objectives

    I understand that coaching is individually tailored to meet the goals and objectives agreed upon by my personal trainer and me. This will typically address three main areas:

    • Exercise/Activity
    • Nutrition
    • Lifestyle/Mindset

    Delivery of the Program

    I understand that coaching will typically and where possible be provided in a pre-agreed format, but that changes in circumstances may necessitate it's delivery through alternative means. I accept that these may include, but are not limited to:

    • Face-to-face sessions
    • Video calls
    • Phone calls
    • Emails
    • Texts

    Description of The Exercise Program

    I understand that my exercise program will involve participation in several types of fitness activities. These activities will vary depending upon the objectives that my personal trainer and I establish, but will probably include:

    • aerobic activities including, but not limited to, the use of treadmills, stationary bicycles, step machines, rowing machines, and cross-trainer
    • muscular endurance and strength building exercises including, but not limited to, the use of free weights, weight machines, calisthenics, and exercise apparatus
    • other activities selected by my personal trainer and agreed upon by me
    • selected physical fitness and body composition tests

    Description of The Nutrition Program

    I understand that my nutrition coaching will involve making changes to what and how I eat. These changes will vary depending upon the objectives that my personal trainer and I establish, but will probably include:

    • increasing or decreasing my intake of certain foods or food groups
    • periodically tracking my food intake via food diary, photographs, calorie or macro-nutrient trackers/apps
    • following a pre-defined program or style of eating for a specified length of time
    • selected nutrition related tests or assessments

    Description of The Lifestyle/Mindset Program

    I understand that my coaching will involve making changes to behaviours, habits and also the way I think about different aspects of my life. These changes will vary depending upon the objectives that my personal trainer and I establish, but will probably include:

    • adopting or adapting specific behaviours
    • short and long term habit change
    • exercises designed to challenge or change the way I think or behave
    • selected psychological or psychometric tests designed to provide better insight into thought and behaviour patterns

    Description of Potential Risks

    • I understand that no exercise program is without inherent risks, regardless of the care taken by a personal trainer and that my personal safety cannot be guaranteed by my personal trainer.
    • I realise that when participating in any exercises, particularly those that induce cardiovascular stress, there is a slight chance of serious injury (e.g., heart attack, stroke, or other cardiovascular accidents) or catastrophic incident (e.g., death, paralysis).
    • Likewise, I know that engaging in muscular endurance, strength building, and other fitness activities sometimes results in minor injuries (e.g., bruises, musculoskeletal strains and sprains), less frequent, more serious injuries (e.g., muscle tears, herniated disks, torn rotator cuffs), and rarely, catastrophic injury (e.g., death, paralysis).
    • I also accept that individual responses to food and nutrition can vary drastically and that modifications to my diet may carry a slight risk of minor issues such as constipation, hunger, cravings and a rare risk of more serious issues such as fainting, allergic reaction or keto-acidosis.
    • I also accept that changes to habits and behaviours may have a small risk of increasing stress levels, psychological discomfort, arguments and changes to relationships and a rare risk of loss of job, breakdown of marriage and estrangement of friends or family.

    Description of Potential Benefits

    I understand that improvement in exercise, nutrition, lifestyle behaviours and a change in mindset have been shown to have definite benefits to general health and well-being. I know that some of the benefits can include, but are not limited to:

    • loss of weight
    • reduction of body fat
    • improvement of blood lipids
    • lowering of blood pressure
    • improvement of cardiovascular function
    • reduction in the risk of heart disease
    • improved strength and muscular endurance
    • improved posture
    • improved flexibility
    • improved self confidence
    • improved performance
    • improved relationships
    • improved communication
    • stress reduction
    • pain reduction

    Participant Responsibilities

    I understand that it is my responsibility to:

    • fully disclose any physical or mental health issues or medications that are relevant to participation in this coaching program
    • cease exercise and report promptly any unusual feelings (e.g., chest discomfort, nausea, vomiting, difficulty breathing, apparent injury) during any aspect of the program
    • clear my participation with my physician

    Participant Acknowledgements

    In agreeing to this exercise program:

    • I acknowledge that my participation is completely voluntary
    • I understand the potential physical risks involved in the exercise program and believe that the potential benefits outweigh those risks
    • I give consent to certain physical touching that may be necessary to coach/ensure proper technique and body alignment
    • I understand that my health or fitness goals require work and attention not just during my sessions, but also outside and the probability of success is directly proportionate to the effort I put in
    • I understand that many factors outside of my coach's control can influence the outcome of my health or fitness goals, including, but not limited to: lifestyle, career, family and social interaction
    • I understand that the achievement of health or fitness goals cannot be guaranteed
    • I have had a voice in planning and approving the activities selected for my exercise program
    • I have been able to ask questions regarding any concerns I might have, and have had those questions answered to my satisfaction
    • I am in good physical condition, have no impairment which might prevent my participation in such activities, and have been advised to consult with a physician prior to beginning this program
    • I understand that during any face-to-face sessions with my trainer present I will be closely supervised. During any other sessions sessions where my trainer is not present or has restricted viewing (such as on a video call), I will be responsible for my own safety. This includes, but is not limited to; ensuring that my surroundings are clear and to keep any distractions, such as pets or small children, away during the session.
    • I understand that during any video or phone sessions, coaching is a means of general guidance and motivation. It is my responsibility to be aware of my own capabilities and to only do what I am comfortable with.
    • If, at any time during a session, supervised or otherwise, I feel undue pain or excessive discomfort I will stop the activity immediatelyand inform my trainer of my symptoms.
    • I understand that all sessions must be paid for in advance
    • I understand that a minimum of 24 hours’ notice of cancellation is required and that failure to provide this will typically result in the session being lost

    By submitting this form, I confirm that: