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PT Health and Safety Form

Please read the following declaration and fill in the form below

EXERCISE PARTICIPATION AND HEALTH DECLARATION

I understand that participation in personal training and exercise activities provided by Samuel Constantinou-Coulter trading as The Viking Lifts involves an element of risk. Activities may include, but are not limited to, cardiovascular exercise, resistance training, mobility work, stretching, fitness assessments, boxing-based exercise, running and other forms of physical activity.

I acknowledge that participation in exercise carries inherent risks, including muscle soreness, strains, sprains, falls, dizziness, aggravation of existing conditions and, in rare circumstances, serious injury or illness.

I confirm that the information provided within this Health Declaration is accurate and complete to the best of my knowledge. I understand that withholding relevant medical information may increase the risks associated with exercise participation.

I understand that it is my responsibility to inform The Viking Lifts of any injury, illness, medical condition, medication, pregnancy, surgery or change in health status that may affect my ability to exercise safely, both now and in the future.

I understand that where appropriate, I may be advised to seek guidance or clearance from my GP or another suitably qualified healthcare professional before participating in exercise.

I voluntarily choose to participate in personal training and exercise sessions provided by Samuel Constantinou-Coulter trading as The Viking Lifts and accept responsibility for monitoring my own physical condition throughout all sessions. I understand that I should immediately inform my coach if I experience pain, discomfort, dizziness, shortness of breath or any other unusual symptoms during exercise.

I acknowledge that no guarantees or warranties have been made regarding specific results, including weight loss, body composition changes, strength improvements, fitness improvements or other performance outcomes.

I understand that personal training sessions are designed to support my health and fitness goals but do not constitute medical advice, diagnosis, treatment or rehabilitation services.

Nothing within this declaration is intended to exclude or limit liability where such liability cannot legally be excluded under the laws of England and Wales.

I confirm that I have read, understood and agree to the contents of this declaration and voluntarily consent to participate in exercise activities provided by The Viking Lifts/Samuel Constantinou-Coulter.

I agree to the terms and conditions as set above
Yes
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Have you been admitted to hospital or received hospital treatment within the last 12 month?
Do you currently have any medical conditions, illness or injury that may affect your ability to exercise safely?
Are you currently taking any prescribed medication?
Has a doctor or healthcare professional ever advised you against participating in exercise or physical activity?
Has a doctor ever told you that you should only undertake physical activity recommended by a healthcare professional?
During physical activity, have you ever experienced:
Are you currently pregnant or have you given birth within the last 12 months?
Is there anything else relating to your health, wellbeing or medical history that may affect your participation in exercise?

DATA PROTECTION & PRIVACY CONSENT


The information provided on this form will be used solely for the purpose of assessing your suitability for exercise, delivering coaching services and helping to ensure your safety during training.

Your information will be stored securely and handled in accordance with UK data protection legislation. It will not be shared with third parties without your consent unless required by law or where necessary to protect your health, safety or wellbeing.

I consent to Samuel Constantinou-Coulter storing and processing the information contained within this form for the purposes outlined above.

I agree to the Data Protection & Privacy Consent Terms
Yes

PHOTOGRAPHY & TESTIMONIAL CONSENT


I give permission for photographs, videos and/or testimonials to be used by Samuel Constantinou-Coulter for marketing and promotional purposes.

I agree to the Photography & Testimonial Consent Terms
Yes
No

CLIENT DECLARATION


I confirm that the information provided within this form is true, accurate and complete to the best of my knowledge.

I understand that it is my responsibility to inform Samuel Constantinou-Coulter of any changes to my health, injury status, medication, pregnancy status or medical condition that may affect my participation in exercise.

I confirm that I have read, understood and agree to the contents of this form.

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Personal Training- Sessions are booked in blocks of 4, 8 and 10+. Payment is required before the 1st session of the new block.

Postponements require a minimum of 24hrs notice. Failure to provide 24hrs notice will result in the session being lost without refund or rescheduling. 

I will attempt to rearrange where possible for the same week but this will be done at my own discretion subject to availability. 

No refunds will be given under any circumstances!

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