ORIGINAL WORKOUT
  • Welcome to Original Workout
  • About OW
  • Fènix Jiu-Jitsu
  • Trainers
    • Rob Goodwin (Founder)
    • Ryan Gant
    • Daniel Fredell
    • Tyler Goodwin
    • Reon Mcilwain
    • Emily Carroll
    • Adabel Mora
    • Zach Fesperman
    • Jacob Creson
    • Jason Bebber
  • Keto-Lifestyle
  • FREE Session
  • Contact
  • Client's Area
  • Wanted: Trainer
  • Welcome to Original Workout
  • About OW
  • Fènix Jiu-Jitsu
  • Trainers
    • Rob Goodwin (Founder)
    • Ryan Gant
    • Daniel Fredell
    • Tyler Goodwin
    • Reon Mcilwain
    • Emily Carroll
    • Adabel Mora
    • Zach Fesperman
    • Jacob Creson
    • Jason Bebber
  • Keto-Lifestyle
  • FREE Session
  • Contact
  • Client's Area
  • Wanted: Trainer
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YOUR CART

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    Client Profile Questionnaire 

    * All information on this questionnaire is private and confidential. No one will read it or have access to it but your trainer. We strongly believe in client / trainer confidentiality.

    Basic Information


    Life & family


    Work

    Simply list a simple example of a typical day's menu

    eating out & foods


    exercise


    Your Body

    1 = Not very, 10 = Most determined I've ever been!! I will not fail!!
    Please upload your current "before" photo(s). We recommend a current photo taken in shorts / spandex shorts and a sports bra 
    *Absolutely no one will see this photo but your trainer. Regular photos are critical for the online training experience to work. Your trainer must visually see you to gauge progress and to determine any  changes in program to ensure success.

    Max file size: 20MB
    Max file size: 20MB
    Max file size: 20MB

    INFORMED CONSENT FOR FITNESS TESTING/PERSONAL TRAINING AND WAIVER OF LIABILITY
    I, the undersigned, do hereby certify that to the best of my knowledge, I am physically able to begin a program of moderate or strenuous exercise and conditioning. I do not have any medical problems or ailments that would put me at risk if I were to become involved in an exercise program. If I am over the age of 42 and unaccustomed to vigorous exercise, I understand that a medical exam, including an EKG test is advised prior to beginning my exercise program. I acknowledge that I have either had a physical examination and consultation with a physician or have been given permission to participate in such activity without the approval of my physician and do hereby assume all responsibility for my participation. I will not hold Original Workout, Rob Goodwin, Nancy Goodwin, any partnership, corporation or DBA thereof, or any employees or individuals contracted by, Original Workout, liable for any injury or injuries. I am entering an exercise program at my own risk with a complete understanding that the strength training, flexibility development, and aerobic/cardiovascular exercise I am about to become involved in is potentially dangerous. I hereby agree to expressly assume and accept any and all risks including -but not limited to -heart attacks, muscle strains, pulls or tears, broken bones, shin splints, heat prostration, knee/lower back/foot injuries, and any other illness, soreness, injury, or death, however caused occurring during or after my participation in the exercise program. I, the undersigned, also understand that any nutrition and nutritional supplementation advice is for information purposes only and is not intended for my individual prescription. And, if I decide to follow any such information I do so at my own risk.
    By initialing and entering your name in the electronic signature box below, you agree to the above waiver of liability and hereby agree that your electronic signature is legally binding.
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