Personal Training Agreement

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					(Your copy to keep)




     Personal Training Agreement
Dear Client,

The purpose of this agreement is to improve performance. All my research and development has
been aimed at creating programmes to assist you in reaching your goals, regardless of your
exercise background. Your personal training sessions will be designed to provide you with the
proper means to achieve your desired results.

I’m very proud of the clients I train, and have very high expectations for them. At the same time,
I stress that as a client you are ultimately responsible for your own achievements. Therefore,
while you are having personal training with me I will expect the following;

    1   MAXIMUM EFFORT
    2   HONESTY
    3   100% COMMITMENT
    4   CONSISTANT ATTENDANCE
    5   ENJOYMENT OF THE SESSIONS
    6   A BIG SMILE!
Please be aware that commitment and attendance are necessary to reach your goals, so I operate
a 24-hour cancellation policy, so if a session is cancelled within twenty-four hours, the full
session price will be met by you.

To be sure to get the most out of your personal training experience, I ask that you sign this
agreement, stating that you’re committed to improving performance and are willing to give
maximum effort and be honest with yourself so that we may strive for excellence together.


        * REMEMBER, RESULTS AREN’T GUARANTEED; THEY’RE EARNED!



Client’s signature: ______________________

Trainer’s signature: _____________________
(My copy, please bring to your first session)




     Personal Training Agreement
Dear Client,

The purpose of this agreement is to improve performance. All my research and development has
been aimed at creating programmes to assist you in reaching your goals, regardless of your
exercise background. Your personal training sessions will be designed to provide you with the
proper means to achieve your desired results.

I’m very proud of the clients I train, and have very high expectations for them. At the same time,
I stress that as a client you are ultimately responsible for your own achievements. Therefore,
while you are having personal training with me I will expect the following;

    7 MAXIMUM EFFORT
    8 HONESTY
    9 100% COMMITMENT
    10CONSISTANT ATTENDANCE
    11ENJOYMENT OF THE SESSIONS
    12A BIG SMILE!
Please be aware that commitment and attendance are necessary to reach your goals, so I operate
a 24-hour cancellation policy, so if a session is cancelled within twenty-four hours, the full
session price will be met by you.

To be sure to get the most out of your personal training experience, I ask that you sign this
agreement, stating that you’re committed to improving performance and are willing to give
maximum effort and be honest with yourself so that we may strive for excellence together.


        * REMEMBER, RESULTS AREN’T GUARANTEED; THEY’RE EARNED!



Client’s signature: ______________________

Trainer’s signature: _____________________
Date        /         /

Title           Forename                       Surname                          Age

Phone (m)                               Phone (h)

Email

How did you hear about me?

If it is an existing client, what is their name?

Have you ever had personal training before?

If yes, for how long and why did you stop?

Have type of exercise have you done in the past/currently do?

Please underline the results you want to achieve;

Weight loss/reduce body fat

Firm up/Increase tone                                     Sports conditioning

Increase endurance/Stamina                          Body sculpting/shaping

Increase energy level                                     Body building/strength

Stress management                                         Other:

Improve self esteem

Improve confidence

Look and feel good

When would you like to achieve your results by?

How many training sessions do you would you like per week?

What days and times would ideally suit you?

What has kept you from starting PT sooner?
How soon are you looking to get started?

Do you have any injuries?                         Is it still a problem?



Health Questionnaire

Answer Y/N to the following;

   1    Has your doctor ever indicated that you have a heart condition?

   2    Have you ever had chest pains brought on by physical exercise?

   3    Has your doctor ever said that your blood pressure was too high?

   4    Do you have a bone, back or muscular problem that might be aggravated by
        exercise?

   5    Do you suffer from epilepsy or asthma?

   6    Do you suffer from diabetes?

   7    Are you pregnant or have you given birth in the last three months?



In signing this form I affirm that I have answered the questions accurately. In the event that
I have been advised to seek medical clearance prior to undertaking exercise, I agree to
contact my GP and take responsibility for obtaining written permission to the
commencement of my exercise programme Hannah Lipman. I understand that I am
responsible for monitoring myself through out the exercise program and that should any
unusual symptoms occur; I will cease participation and inform the doctor of those symptoms.
I understand that I must notify you of any change in my health. I shall carry out all
appropriate safeguards to ensure that the information you have provided will remain secure
and accurate and request that you keep me updated with any changes to the information.
Signature by you of this declaration shall constitute your explicit consent to the use and
retention by Hannah Lipman of such information in the manner and for the specified
purpose set out in this declaration.


Name:                          DoB:      /   /      Signed:                    Date

Name: Hannah Lipman            Signed:                    Date
GP Referral :
Name of doctor                         Address of surgery

Signed                         Date




Personality Questionnaire


Answer Y/N or Sometimes to the following:

   1     Are you very good at committing yourself to doing things?

   2     If something is too difficult are you likely to simply just give up?

   3     Do you have a lot of self motivation?

   4     If you tell somebody you’ll do something can they depend on you to do it?

   5     Do you like to set goals and work towards them?

   6     Would you consider yourself to very self disciplined?

   7     Do you like to take on tasks that challenge you?

   8     When you reach a planned goal do you plan a higher one?

   9     Do you ever work to your full capacity?

If there is anything you would like to share with me to help get the best out of you in the
training sessions, please use the space provided below
(I.e. motivations, fears, strengths, weaknesses)
Goal Orientation

Research shows that your success is linked to setting out goals. Goals being targets which
you intend to achieve. Experience shows that those with clearly thought out goals will
achieve much more.

I would like you write down the goals you plan to achieve and then indicate where you feel
you are right now in relation to that goal (10 = goal achieved). I will then take each goal and
break it down into short term goals which are specific, measurable, achievable and timed.

Goals                                        Scale
1.                                           1.      2.      3.      4.      5.      6.
                                             7.      8.      9.      10.
2.                                           1.      2.      3.      4.      5.      6.
                                             7.      8.      9.      10.
3.                                           1.      2.      3.      4.      5.      6.
                                             7.      8.      9.      10.

I will regularly review your goals with you, enabling you to appreciate the achievements you
have made, and ensuring the success of each goal.

It is important for me to get to know you a little more, please elaborate on the following
topics in relation to yourself currently;

Exercise Knowledge


Exercise habits


Nutrition Knowledge
Nutrition Habits


Happiness


Energy


Confidence in others


Confidence in yourself




(This is Optional, but very useful for recording progress)




                                               Vital Statistics
                                                                  Date:
                                                                  Time:


Body Fat %
(Please do not attempt this on your own)


Bicep:

Triceps:

Iliac Crest:

Sub scapulae:

Total:
Body Fat %

Blood Pressure:              /



Measurements
(You can complete this at home or I will do it)


Weight:

Waist Belly Button:

Chest:

Hip:

Bicep:

Quad: