Important: This form must be completed honestly and in full before commencing any training. The information you provide enables your Personal Trainer to design a safe and appropriate programme. Providing false or incomplete information increases your risk of injury.
Section A — Client Details
Full name:
Date of birth:
Address:
Email:
Phone:
Section B — Emergency Contact
Emergency contact name:
Relationship to you:
Emergency contact phone:
Section C — PAR-Q Health Screening
The Physical Activity Readiness Questionnaire (PAR-Q) is an industry-standard health screening tool. Please answer each question honestly. A "Yes" answer to any question does not necessarily mean you cannot exercise — it means your trainer needs more information.
Has a doctor ever said that you have a heart condition and recommended only medically supervised physical activity?
Do you feel pain in your chest when you do physical activity?
In the past month, have you had chest pain when not doing physical activity?
Do you lose your balance because of dizziness, or do you ever lose consciousness?
Do you have a bone or joint problem (e.g. back, knee, hip, shoulder) that could be made worse by a change in your physical activity?
Are you currently pregnant or have you given birth in the last 12 weeks?
Are you currently taking prescribed medication for blood pressure, heart condition, diabetes, or any other condition that could affect your ability to exercise safely?
Is there any other reason why you should not do physical activity or exercise?
If you answered Yes to any of the above, please provide details below, and discuss with your trainer before commencing:
Section D — Medical Clearance
Where the PAR-Q identifies a potential health concern, the Client agrees to obtain written medical clearance from their GP before commencing training. I confirm:
I have sought GP clearance (if required based on my PAR-Q responses above), and have provided confirmation to my trainer.
Section E — Assumption of Risk
I, the undersigned, acknowledge and agree that:
(a) Physical exercise carries inherent risks, including but not limited to: muscle soreness, fatigue, cardiovascular strain, and risk of injury;
(b) I have disclosed all relevant health conditions, injuries, and medications to my Personal Trainer, and I accept responsibility for any consequences arising from information I have withheld;
(c) I voluntarily assume all risks associated with participating in personal training sessions with [Business Name];
(d) I will inform my trainer immediately if I experience any pain, dizziness, shortness of breath, or discomfort during a session;
(e) I understand that my Personal Trainer is not a medical professional, and nothing communicated during sessions constitutes medical advice; and
(f) The Trainer's liability for injury is limited to circumstances where injury results directly from the Trainer's proven negligence, and I agree not to hold [Your Name] or [Business Name] liable for any injury arising from risks I have accepted in this waiver.
Section F — GDPR Consent
The health and fitness information in this form is special category data under UK GDPR. By signing below, I give my explicit consent for [Business Name] to collect, store, and use this information solely for the purpose of designing and delivering safe personal training services. I understand that I may withdraw this consent at any time by contacting my trainer in writing.