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Where the BEST begin
About
Join
Trainers
Class Schedule
Login/Register
Store
Name
*
First Name
Last Name
Date of Birth
MM
DD
YYYY
Grade in School
Address
Address 1
Address 2
City
State/Province
Zip/Postal Code
Country
Phone Number
(###)
###
####
Email
*
Parent/Guardian Information
Parent/Guardian Name
First Name
Last Name
Parent/Guardian Address
Address 1
Address 2
City
State/Province
Zip/Postal Code
Country
Parent/ Guardian Email
Parent/Guardian Phone
(###)
###
####
Emergency Contact
Emergency Contact Information
First Name
Last Name
Emergency Contact Phone
(###)
###
####
Relationship to Client
Medical History
Name of Physician
First Name
Last Name
Phone Number of Physician
(###)
###
####
High Blood Pressure
Yes
No
Heart Conditions
Yes
No
Diabetes
Yes
No
Hypoglycemia
Yes
No
Corrective Eyewear
Yes
No
High Cholesterol
Yes
No
Epilepsy or Seizures
Yes
No
Thyroid Condition
Yes
No
Neural Limitations
Option One
Option Two
Allergies
Yes
No
Hypertension
Yes
No
Other
Are you currently taking any medications?
Yes
No
If yes, please list here:
Recent or chronic injuries?
Date of last physical
MM
DD
YYYY
Signature of client or parent/guardian
*
I hereby authorize that I have been cleared by a medical professional to partake in physical activity and the agreed training program
Thank you!