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Home > Site DocRoot 2013 > Get Started Now > Pre-Training Questionnaire
 

Pre-Training Questionnaire

Please complete one form per participant, using unique email addresses for each participant.

Contact Details

Please fill in your contact details.

Firstname:*
Surname:*
Phone - Mobile:*
Email:*
Date of Birth:*    
Gender:*
Street Home:*
City/Suburb:*
State:*
Postcode:*
Choose your area and session time:*
Describe your current exercise regime:
Are you bringing someone with you?

Enter their name and number or email address and we will contact them to get everything sorted.
Do you currently have any of the following (or have a history of)?
Allergy induced asthma
Any heart/stroke condition
Arthritis
Asthma
Diabetes
Exercise induced asthma
High Blood Pressure >140/90
High Cholesterol/triglycerides
Liver/Kidney Condition
Pregnant
Do you have any current injuries or is there anything else that might affect your ability to participate?
Do you have any allergies?
Are you on any medication? If so what.
What is the most important thing that you want to get out of your training with us ?
Please provide someone who we should contact for you in case of emergency (name / number):*
Declaration and waiver:*

I understand that I am responsible for my own participation in any activities undergone in evolution classes or associated training and events. I have answered all questions regarding any medical history and recent medical treatments received by me and will continue to inform Evolution to Wellbeing of any information which will affect my health and wellbeing in regard to my participation in any program.
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Meet our clients

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Contact Us

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Firstname:*
Surname:*
Phone - Mobile:*
Email:*
Postcode:
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