Client agreement Step 1 of 9
Section 1 · Client details

Client Agreement & Health Screening

Please complete and sign this form before your first in-person personal training session with Lily Allmond, trading as Lily Rose Fitt. Read every section carefully and ask if anything is unclear.

Date of birth
Section 1 · Client details

Emergency contact and GP

Someone Lily can call if you ever need help during a session.

Section 1 · Client details

Your training

So Lily can plan sessions around you.

Training experience
Section 2 · Health screening (PAR-Q)

Health screening

If you answer YES to any question, you must get written clearance from your GP or a medical professional before training starts.

1Has a doctor ever said you have a heart condition or should only do exercise recommended by a doctor?

2Do you feel pain in your chest during physical activity, or have you in the past month when not active?

3Do you ever lose your balance because of dizziness, or have you ever lost consciousness?

4Do you have high or low blood pressure, or take medication for your blood pressure or heart?

5Do you have diabetes, asthma, epilepsy or any other ongoing medical condition?

Section 2 · Health screening (PAR-Q)

Health screening, continued

Five more questions. Please answer every one.

6Do you have a bone, joint, muscle or back problem that could be made worse by exercise?

7Have you had surgery, an injury or a fracture in the last 12 months?

8Are you pregnant, or have you given birth in the last 12 months?

9Are you taking any prescribed medication?

10Is there any other reason you know of why you should not do physical activity?

! You answered YES to one question. You must get written clearance from your GP or a medical professional before training starts.
Sections 3 and 4

Risks and your responsibilities

Please read both sections, then tick the box at the bottom.

3. Informed consent and risks of exercise

I understand that resistance training, cardiovascular exercise and other physical activity carry some risk, even when properly supervised. These risks include, but are not limited to:

  • muscle soreness, strains and sprains
  • joint, back or ligament injury
  • dizziness, fainting or nausea
  • in rare cases, heart problems or other serious medical events

I choose to take part voluntarily. I understand that results vary from person to person and are not guaranteed.

4. Client responsibilities

I agree that I will:

  1. Give complete and honest answers on this form and tell Lily before each session about any change in my health, injuries, medication or pregnancy.
  2. Tell Lily straight away if I do not understand an instruction, or feel I cannot safely do an exercise, weight or number of reps.
  3. Only attempt exercises, loads and intensities that I feel physically able to do, and never push beyond my own limits.
  4. Stop immediately and tell Lily if I feel pain, dizziness, chest discomfort, shortness of breath or feel unwell in any way.
  5. Wear suitable clothing and footwear, bring water, and not train after drinking alcohol or taking non-prescribed drugs.
  6. Follow the rules and safety instructions of the gym or venue where sessions take place.
  7. Not use equipment or attempt exercises outside of sessions based on instructions I have not fully understood.

I understand that Lily can adapt, pause or end a session, or ask for GP clearance, if she has concerns about my safety.

Sections 5 and 6

Scope of service and liability

Please read both sections, then tick the box at the bottom.

5. Scope of service

Lily is a personal trainer, not a doctor, physiotherapist, dietitian or other medical professional. I understand that:

  • sessions provide exercise instruction and coaching only
  • Lily does not diagnose, treat or rehabilitate injuries or medical conditions, and does not provide massage or manual therapy
  • any nutrition guidance is general healthy-eating advice, not a medical or clinical diet
  • in an emergency Lily may give first aid only and will call the emergency services where needed

I will seek advice from a qualified medical professional for any injury, pain or health concern.

6. Liability and insurance

Lily Allmond holds Public and Teacher Liability insurance for her work as a fitness instructor.

I accept that Lily is not responsible for any injury, illness, loss or damage caused by:

  • information I have withheld or given incorrectly about my health
  • my failure to follow instructions or to tell Lily I could not safely do an exercise
  • exercise I do outside of supervised sessions
  • loss of or damage to my personal belongings at the venue

Nothing in this agreement limits or excludes Lily's liability for death or personal injury caused by her own negligence, or any other liability that cannot be excluded by law.

Section 7

Data protection

How your information is stored and used.

7. Data protection

Lily will store the personal and health information on this form securely and use it only to plan safe training and to contact your emergency contact if needed. It will not be shared with anyone else unless the law requires it or it is needed in an emergency. You can ask to see or delete your information at any time. Records are kept for the length of your training and for a reasonable period afterwards for insurance purposes.

Section 8

Declaration

Last step. Confirm, sign and send.

8. Declaration

I confirm that I have read and understood this agreement, that the information I have given is true and complete, and that I am aged 18 or over. I agree to tell Lily about any changes to my health before future sessions.

Signature
Sign here with your finger

Date:

✓

All signed, thank you

Your client agreement and health screening have been sent to Lily.

If anything about your health changes before a session, tell Lily before you train.

! You answered YES to at least one health question. Please get written clearance from your GP or a medical professional and give it to Lily before training starts.
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