Header Store

Special 4u

Get in touch with us

We can answer all your questions about MCX lifestyle.

Share on Your Social Network

We value our MCX Lifestyle Community. Share your journey with your personal and professional network and help more people experience the MCX Lifestyle.

Health Assessment

Client Information Package

This questionnaire will help us know you better before any activity. We heads up you if is necessary for you to seek further advice from your doctor or a another qualifed professional before becoming to start training.

Name *

Address *

Phone *

Email *

Occupation *

Date of Birth *

Emergency Contact

Name *

Phone *

Relationship *

Parent Information

Name

Phone

Parent Guardian

Fitness Related Questions

Sports or training history if any

How often do you currently participate in physical activity?

Fitness Goals

What are your current barriers preventing you from reaching your goals?

Any major fluctuations in weight in the past 12 months?

Please describe your level of physical activity at your workplace (i.e., sitting/standing)

What is your ideal time to train? Please list days and times

Is there any other information that we need to know before scheduling your appointment? (Medical conditions, previous injuries/old sports injuries, medications currently taking)

Height?

Weight?

Lifestyle and Behavior Related Questions

How many meals/snacks a day do you eat? *

How often do you eat out each day? *

How many glasses of alcohol do you drink per week? *

Do you take vitamins or supplements? *

Please list

Are you a smoker? *

How many hours do you regularly sleep at night? *

Participant Agreement

Congratulations on your decision to participate in an exercise program! With the help of your kinesiologist/personal trainer/coach, you greatly improve your ability to accomplish your training goals faster, safer, and with maximum benefits. The details of these training sessions can be used for a lifetime.

In order to maximize progress, it will be necessary for you to follow program guidelines during supervised and unsupervised training days. Remember, exercise and healthy eating are equally important! During your exercise program, every effort will be made to assure your safety. However, as with any exercise program, there are risks, including increased heart stress and the chance of musculoskeletal injuries. In registering for this program, you agree to assume responsibility for these risks and waive any possibility for personal damage. You also agree that, to your knowledge, you have no limiting physical conditions or disability that would preclude an exercise program.

By signing below, you accept full responsibility for your own health and well-being AND you acknowledge an understanding that no responsibility is assumed by the leaders of the program.
It is recommended that all program participants work with their kinesiologist/personal trainer three (3) times per week. However, due to scheduling conflicts and financial considerations, a combination of supervised and unsupervised workouts is possible.

Personal Training Terms and Conditions

1. MCX Lifestyle sessions that are not rescheduled or cancelled 48 hours in advance will result in forfeiture of the session and a loss of the financial investment at the rate of one session.

2. Clients arriving late will receive the remaining scheduled session time, unless other arrangements have been previously made with the trainer.

3. The expiration policy requires completion of all MCX Lifestyle sessions within 90 days from the date of the contract. Personal training sessions are void after this time period.

4. No personal training refunds will be issued for any reason, including but not limited to relocation, illness, and unused sessions.

I agree

admin-rafael