No Limits 30 Day Test

This is where I get to know about who you are as an athlete. Feel free to add as much information as necessary.

Question Title

* 1. Please complete the following

Name

Phone #

Age

Briefly describe your previous and current athletic history:

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* 2. What are your previous best times in the following?

Sprint Distance

Olympic distance

Half Ironman

Ironman

5 Km Run

10 Km Run

Half Marathon

Marathon

500m swim

1500m swim

40 Km Bike

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* 3. If you trained previously for a triathlon, biking or running event, please answer the following questions.

How many years have you been training?

Last year, how many months did you train?

Which months, if any, did you take for recovery?

On average, approximately how many hours per week did you train?

How many hours did you train last year (if known)?

Did you follow a periodization schedule? Yes or No

Did you follow any yearly plan? If yes briefly explain

Did you incorporate any weight training into your program? If yes briefly explain

What distance of race(s) are you training for?

How many available hours per week do you have to train?

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* 4. Do you have any current injures or physical limitations that we should be aware of?

Yes

If Yes please list

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* 5. Please list the days that you want to train on? Eg Swim on Monday

Monday

Tuesday

Wednesday

Thursday

Friday

Saturday

Sunday

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* 6. Are you currently participating in any other classes during the week? If so what type of class, on what day and how long is each class?

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* 7. What are your current Training Zones? Fitness level?

Anaerobic Threshold for Bike

Anaerobic Threshold for Run

Zone 1

Zone 2

Zone 3

Zone 4

Zone 5

other

Don't know

What is your current level of fitness on a scale of 1 to 10? (1 being totally unfit and 10 being your fittest ever)

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* 8. Please list the name of the triathlon you are training for

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* 9. By signing this form, you agree, warrant and covenant as follows:

This agreement is between (Member) and Todd Malcolm operating as No Limits.
1. Term and Compensation
A. Term
This Agreement commences upon the date No Limits receives a completed copy of this Agreement by Member ("Effective Date").

B. Coaching Service Fees
Member understands and agrees to the monthly fees with the associated program listed on the sign up page, $50 for 30 days.

C. Coaching Services
Member understands that he/she will receive the Services purchased under this Agreement. Member agrees that e-mail correspondence shall be initiated by Member or No Limits.

2. Termination
Member acknowledges and agrees that after 30 days services between No Limits and Member will be terminated. If further coaching is warranted, Member will sign up for a No Limits Coaching program at agreed upon fee.

3. Confidentiality
Member agrees that the Services provided under this Agreement are strictly confidential and may not be disclosed to any third party without the express written consent of No Limits, including but not limited to, the materials provided to Member from No Limits, and the substance of the communications between No Limits and the Member.

4. Waiver and Release of Liability, Assumption of Risk and Indemnity
MEMBER HEREBY ACKNOWLEDGES THAT NO LIMITS MAKES NO WARRANTIES AND DOES NOT GUARANTEE INDIVIDUAL RESULTS. MEMBER, NOT NO LIMITS, IS PERSONALLY RESPONSIBLE FOR THE ACHIEVEMENT OF INDIVIDUAL PERFORMANCE GOALS. MEMBER FURTHER UNDERSTANDS AND ACKNOWLEDGES THAT ATHLETIC TRAINING IS INHERENTLY DANGEROUS AND CARRIES WITH IT THE POTENTIAL FOR EACH, SERIOUS INJURY AND PROPERTY LOSS. MEMBER UNDERSTANDS AND AGREES THAT MEMBER ASSUMES THE RISK OF PARTICIPATING IN THE TRAINING AND ACTIVITIES RECOMMENDED BY NO LIMITS. MEMBER CERTIFIES THAT HE or SHE IS PHYSICALLY FIT AND SUFFICIENTLY TRAINED FOR PARTICIPATION IN THESE SERVICES AND THAT MEMBER HAS NOT BEEN ADVISED AGAINST PARTICIPATION BY A QUALIFIED HEALTH PROFESSIONAL. IN CONSIDERATION OF THIS AGREEMENT, MEMBER HEREBY INDEMNIFIES, RELEASES AND FOREVER DISCHARGES NO LIMITS FROM ANY LIABILITY, CLAIMS, LOSSES, COSTS, OR EXPENSES, AND WAIVES THE RIGHT TO PURSUE LEGAL ACTION AGAINST NO LIMITS ARISING DIRECTLY OR INDIRECTLY FROM MEMBER'S PARTICIPATION IN THE SERVICES, INCLUDING CLAIMS OR DAMAGES RESULTING FROM DEATH, PERSONAL INJURY, PARTIAL OR PERMANENT DISABILITY OR PROPERTY DAMAGE, MEDICAL OR ECONOMIC LOSSES. THIS AGREEMENT SHALL BE BINDING UPON MEMBER'S HEIRS, ASSIGNEES, SUCCESSORS AND PERSONAL REPRESENTATIVES. MEMBER HEREBY FURTHER STATES THAT HE/SHE CURRENTLY SUFFERS FROM NO PHYSICAL OR MENTAL CONDITION THAT WOULD IMPAIR HIS/HER ABILITY TO FULLY PARTICIPATE IN THIS AGREEMENT. MEMBER REPRESENTS AND WARRANTS THAT HE/SHE IS EIGHTEEN (18) YEARS OF AGE OR OLDER.

5. Governing Law
This Agreement shall be construed under and in accordance with the laws of the province of Alberta exclusive of any conflict-of- law or choice of law rules and principles. Any disputes arising from this contract will be brought in the forum of Alberta.

YOU SHOULD READ THIS AGREEMENT CAREFULLY BEFORE ACCEPTING ITS TERMS. YOU UNDERSTAND AND AGREE THAT THE SERVICES ARE PROVIDED TO MEMBERS EXCLUSIVELY UNDER THIS AGREEMENT BY NO LIMITS. BY SIGNING BELOW, YOU ARE STATING THAT YOU HAVE READ AND UNDERSTAND THIS AGREEMENT; AND THAT YOU IRREVOCABLY AGREE TO ALL OF THE TERMS OF THIS AGREEMENT AS UPDATED BY NO LIMITS FROM TIME TO TIME. IF YOU DO NOT AGREE TO ALL OF THE TERMS OF THIS AGREEMENT, NO LIMITS WILL PROMPTLY CANCEL THIS TRANSACTION. CONTINUED ACCEPTANCE OF AND COMPLIANCE WITH THE TERMS OF THIS AGREEMENT ARE A CONDITION OF NO LIMITS PROVIDING THE SERVICES.

Name

Do you agree? Yes or No?

Date

Question Title

* 10. Par - Q (please complete the following questions)

	Yes	No
Has your doctor ever said that you have a heart condition and that you should only do physical activity recommended by a doctor? Yes or No?	Has your doctor ever said that you have a heart condition and that you should only do physical activity recommended by a doctor? Yes or No? Yes	Has your doctor ever said that you have a heart condition and that you should only do physical activity recommended by a doctor? Yes or No? No
Do you feel pain in your chest when you do physical activity? Yes or No	Do you feel pain in your chest when you do physical activity? Yes or No Yes	Do you feel pain in your chest when you do physical activity? Yes or No No
In the past month, have you had chest pain when you were not doing physical activity? Yes or No	In the past month, have you had chest pain when you were not doing physical activity? Yes or No Yes	In the past month, have you had chest pain when you were not doing physical activity? Yes or No No
Do you lose your balance because of dizziness or do you ever lose consciousness? Yes or No	Do you lose your balance because of dizziness or do you ever lose consciousness? Yes or No Yes	Do you lose your balance because of dizziness or do you ever lose consciousness? Yes or No No
Do you have a bone or joint problem (for example, back, knee or hip) that could be made worse by a change in your physical activity? Yes or No	Do you have a bone or joint problem (for example, back, knee or hip) that could be made worse by a change in your physical activity? Yes or No Yes	Do you have a bone or joint problem (for example, back, knee or hip) that could be made worse by a change in your physical activity? Yes or No No
Is your doctor currently prescribing drugs (for example, water pills) for your blood pressure or heart condition? Yes or No	Is your doctor currently prescribing drugs (for example, water pills) for your blood pressure or heart condition? Yes or No Yes	Is your doctor currently prescribing drugs (for example, water pills) for your blood pressure or heart condition? Yes or No No
Do you know of any other reason why you should not do physical activity? Yes or No	Do you know of any other reason why you should not do physical activity? Yes or No Yes	Do you know of any other reason why you should not do physical activity? Yes or No No
Is the information you have entered in this questionnaire accurate and true?	Is the information you have entered in this questionnaire accurate and true? Yes	Is the information you have entered in this questionnaire accurate and true? No

If you answered Yes to one or more questions. Talk with your doctor by phone or in person BEFORE you start becoming much more physically active or BEFORE you have a fitness appraisal. Tell your doctor about the PAR-Q and which questions you answered YES.