Consultation -

Step 1:

The first step is done. Just by clicking here and taking action in a healthier lifestyle.

Step 2:

Thoroughly fill out the consultation and we’ll put together the best program to get you your results!

Step 3:

We will contact you within 24 hours to tell you about your program length, cost, assess your body composition, and get started.

First Name

Last Name

Telephone

Date of birth - day

Date of birth - month

Date of birth - year

Tell us about yourself, current exercise, and goals you want to achieve.

What active lifestyle do you currently live?

How long have you been weight training to achieve your goals?

0-3 years 3-5 years 5+ years

How would you rate your fitness level?

Brand new Beginner Intermediate Advanced

Tell us what days and times work best for you to train with us.

Do you have any physical or daily barriers holding you back?

How would you describe yourself once you have achieved your results?

PAR-Q Medical Release Form - Answer "yes" or "no" to all of the questions listed below.

Has your doctor every said that you have a heart condition?

No Yes

Has your doctor every said that you have high blood pressure?

No Yes

Do you feel pain in your chest while at rest, during daily activities of living or during physical activity?

No Yes

Do you lose balance because of dizziness OR have you lost consciousness in the last 12 month due to physical over exertion?

No Yes

Have you ever been diagnosed with a medical condition (other than a heart condition or high blood pressure?)

No Yes

Are you currently taking medicinal medication for any chronic conditions and/or illness?

No Yes

If you have answered "yes" to the above questions please list condition(s).

Do you currently (or have had within the last 12 months) a bone, joint, or soft tissue (muscle, ligament, or tendon) problem that could be made worse by becoming more physically active?

No Yes

If you have answered "yes" to the above questions please list condition(s).

PAR-Q agreement to terms.

I agree that everything that I have stated above to be truthful and take full responsibility if falsified to any degree. If I have answered "yes" to any of the questions that I must get clearance from a doctor for any type of physical activity prior to training with Bold Athletics + Fitness.

Tel: 780.328.0101

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