ASSESSING YOUR NEEDS: All information received on this form will be treated as strictly confidential. Please fill out the forms completely and accurately. This information is essential to helping TMF develop a program that addresses your needs, goals and interests and is safe and effective.
If you answered NO honestly to all PARQ questions, you can be reasonably sure that you can: Start becoming much more physically active begin slowly and build up gradually. This is the safest and easiest way to go. Take part in a fitness assessment this is an excellent way to determine your basic fitness so that you can plan the best way for you to live actively. It is also highly recommended that you have your blood pressure evaluated. If your reading is over 144/94, talk with your doctor before you start becoming much more physically active.
Goal Setting
In order to increase your chances of being successful at achieving your goals, a certain protocol
should be followed. Please ensure all your goals are ‘SMART’.
S = Specific (Provide details, how long, how much etc.)
M = Measurable (How will you measure whether you’ve reached your goals)
A = Attainable (Be realistic, set smaller goals)
R = RewardsBased (Attach a reward to each goal)
T = Time Frame (Set specific dates for goals)
I wish to participate in the training and nutrition program offered by TMF. I understand there are inherent risks in participating in a program of strenuous exercise. Consequently, I have been examined by a physician of my choice and have obtained his/her approval for my participation in a fitness program within sixty (60) days of the date set forth below. No change has occurred in my physical condition since the date such approval was given which might affect my ability to participate in the fitness program. If a physician has not examined me, I agree to see a physician within sixty (60) days of the date set forth below to obtain his/her approval for my participation in a fitness program. I agree that TMF or any of their contracted third party trainers, shall not be liable or responsible for any injuries to me resulting from my participation in the fitness program (whether at home, outdoors, or at a corporate, commercial, residential or other fitness facility) and I expressly release and discharge TMF its owners, employees, agents and/or assigns, from all claims, actions, judgments and the like which I or my heirs, executors, administrators or assigns may have or claim to have as a result of any injury or other damage which may occur in connection with my participation in the fitness program, excepting only an injury caused by the gross negligence or intentional act of such person or persons. This Release shall be binding upon my heirs, executors, administrators and assigns.
I have read and understand this term: ________(type name above and date)
2) I certify that the answers to the questions outlined on the PARQ
form are true and complete to the best of my knowledge. I acknowledge that medical clearance has been
attained if I have answered “Yes” to any of the questions on the PARQ form.
I understand and agree that it is my responsibility to inform my Personal Trainer of any
conditions or changes in my health, now and on going, which might affect my ability to
exercise safely and with minimal risk of injury.
I have read and understand this term:________(type name above & date)
I have read this Release and Terms of Agreement and I understand all of its terms. (type name above & Date)
Email front, back & side photos of yourself wearing two piece swimsuit or sports bra & bike shorts (shorts only for males) to Tony at Tonymorrisfitness@gmail.com. If you have any questions prior to signing up, please call our office at 310.401.6903.