Exit this survey No Limits Iron Distance Training Program Question Title * 1. Please complete the following Name Phone # Email Age Briefly describe your previous and current athletic history: Question Title * 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 Question Title * 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? Question Title * 4. Do you have any current injures or physical limitations that we should be aware of? Yes No If Yes please list Question Title * 5. Please list the days that you want to train on? Eg Swim on Monday Monday Tuesday Wednesday Thursday Friday Saturday Sunday Question Title * 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? Question Title * 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) Question Title * 8. Please list the Iron Distance race(s) that you have signed up for. Question Title * 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 CompensationA. TermThis Agreement commences upon the date No Limits receives a completed copy of this Agreement by Member ("Effective Date"). B. Coaching Service FeesMember understands and agrees to the monthly fees with the associated program listed on the sign up page, $215+GST a month.C. Coaching ServicesMember 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. It is up to the member to provide questions prior to the 4 week video to ensure that their questions are answered .2. Termination Member acknowledges and agrees that Member may terminate a Renewal Term without cause provided that Member has indicated in writing Member's intention not to renew at least fifteen (15) days prior to the expiration of the Renewal Term.3. ConfidentialityMember 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 IndemnityMEMBER 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 LawThis 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. Done