Just Train

New Client Form

 

Medical Clearance

We welcome everyone, regardless of what level they’re starting at. We are all about the individual’s journey, so you only have to live up to your own standards. Get ready to have fun and get fit on your own terms. Please fill out all forms before your first session with Jody.

 
Name *
Name
Primary Phone *
Primary Phone
Relationship to client
Sex *
Date of Birth *
Date of Birth
Address *
Address
Check all that apply
Please copy & paste below items into your answer for response: Running/Jogging: Walking: Stair Climbing: Bicycle/Spinning: Weight Training: Aerobics Classes: Swimming: Racquet Sports: Skiing/Snowboarding: Yoga/Martial Arts: Other:
Goals Questionnaire *
These questions will help me to understand your personal fitness goal. It is also a "contract" in which I ask you to make a commitment to 3 concrete steps towards fitness and health. It is not a legal contract, but rather a personal contract that you make with yourself and others concerned with your health. Please indicate your personal health and fitness-related goals:

Waiver

 

Personal Training Program Policies:

Each participant must sign a waiver and complete a health history questionnaire to be kept on file and will be confidential between the personal trainer and the client. Please notify Jody Trostler by calling 216-577-1987 24 hours in advance to cancel a session. Clients will be charged for sessions without 24 hour notice

Assumption of Risk for Participation in the Personal Training:

Each participant should realize that there are substantial risks, hazards, and danger inherent in training. Each participant must be covered under an accident and health insurance policy. It is the responsibility of each participant to participate only in those activities for which he/she has prerequisite skills, qualifications, preparation and training (as determined and instructed by the personal trainer). Therefore, in consideration of the benefits received from the personal training program, the undersigned assumes all risks of damages or injury that may be sustained by him/her while participating in a exercise activity or in travel to or from such activity.

Release, Covenant Not to Sue, and Waiver :

Personal Training involves an inherent risk of physical injury and the undersigned assumes all such risks. The undersigned hereby agrees that for the sole consideration of Jody Trostler allowing the undersigned to participate in the Personal Training Program for which or in connection with which Jody Trostler has made available any equipment or facilities, the undersigned does hereby release, covenant not to sue, and forever discharge Jody Trostler of any and for all claims, demands, rights, and causes of action of whatever kind or nature, including unforeseen bodily and personal injuries, damage to property, and the consequences thereof resulting from participation in any way connected with such recreational programs and activities. The undersigned understands that this Release, Covenant Not to Sue, waiver, and Assumption of Risk shall be effective from the date of signature until the effective termination of the personal training services by Jody Trostler. By signing this document, the undersigned hereby acknowledges that he/she has read the above carefully before signing, and agrees to comply with all the above.

 
Name
Name
Mailing Address *
Mailing Address
Date of Birth *
Date of Birth
Emergency Contact Name *
Emergency Contact Name

Nutrition & Weight Profile:

 
Name *
Name
Do you have parents or siblings that are over weight? *
Is this a good time in your life to be starting a weight loss program? *
Think about possible pressing responsibilities, unusual stressors or distractions.
Which do you regularly eat? *
Check all that apply.
What size portions do you normally have? *
Do you eat while doing other activities? *
(e.g. watching t.v., reading, working)
cookies, cake, pie candy doughnuts ice cream commercial muffins