Personal Training Intake + Liability Waiver

Client Information

First Name

Last Name

Email Address

Phone Number

Date of Birth

Emergency Contact

First Name

Last Name

Phone Number

Training Type

(Select all that apply)

Strength

Mobility/Flexibility

Injury Prevention

Trauma Informed Movement

Functional/Movement-Based Movement

Weight Management/Body Composotion

General Health & Wellbeing

Sport or Performance-Specific Training

What are your primary movement goals?

Physical Activity Readiness (PAR-Q)

Has your doctor ever said that you have a heart condition or recommended only medically supervised activity?

Do you feel pain in your chest when you perform physical activity?

In the past month, have you had chest pain when NOT performing activity?

Do you lose your balance because of dizziness or do you ever lose consciousness?

Do you have a bone or joint problem that could be made worse by a change in physical activity?

Is your doctor currently prescribing medications for blood pressure or a heart condition?

Do you know of any other reason you should not engage in physical activity?

None

If you checked of the above, please describe and confirm whether you’ve received clearance from your healthcare provider:

Injury/Medical History

Do you have any current or past injuries or medical conditions (e.g., surgeries, musculoskeletal injuries, chronic illness, physical limitations)?

Injury/Medical History

Yes

If yes please provide details:

Are you currently under the care of a physician, physical therapist, or other health professional?

Yes

If yes, please list type of provider and reason:

Have you been medically cleared to participate in a fitness program?

Yes

Current Physical Activity Level

How many days per week are you available for training?

Please describe your current exercise routine (if applicable):

Preferred session format?

In-person

Virtual/Online

Combination/Flexible

Do you have access to any equipment? (Check all that apply)

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None (bodyweight only)

Dumbbells

Resistance Bands

Kettlebells

Barbell/Full Gym Access

Other:

Is there anything else you’d like your trainer to know in order to support you effectively?

Personal Training Agreement + Liability Waiver

I understand that personal training through Full Intentions Movement involves physical exercises that may cause injury and that I freely and voluntarily consent to participate.
I represent that I am physically able to participate and have either received medical clearance or voluntarily choose to participate without such clearance.
I agree to disclose any changes to my health status and communicate any pain, dizziness, or discomfort during training sessions.
I understand that personal training is not medical treatment, physical therapy, or rehabilitation and that my trainer will not diagnose or prescribe medical treatments.
I knowingly and freely assume all risks associated with participation in personal training, and hereby release and hold harmless Full Intentions Movement and its employees/contractors from any and all liability for injury or damages arising from my participation.

Liability Waiver Agreement

I have read and understand this agreement and consent to participate in personal training services. I agree that if there are contents in this agreement that I do not understand I will reach out to info@fullintentions.life

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I agree

Signature

We're looking forward to working with you!

Personal Training Intake + Liability Waiver

Client Information

Emergency Contact

Training Type

(Select all that apply)

What are your primary movement goals?

Physical Activity Readiness (PAR-Q)

Injury/Medical History

Current Physical Activity Level

How many days per week are you available for training?

Is there anything else you’d like your trainer to know in order to support you effectively?

Personal Training Agreement + Liability Waiver

Liability Waiver Agreement

Full Intentions, PLLC