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TIGER COACHING PERSONAL TRAINING APPLICATION
To initiate a coaching/training program with us, please print this form (in hard copy) and answer the questions as accurately as you can. Add additional sheets if you need more space. We will obtain more detailed information during our first meeting/phone consultation. Mail this form with your corresponding application fee to:
This form in MicroSoft Word Format!
 Tiger Coaching Fitness Contract!
Tiger Coaching & Personal Training "GOAL SETTING PACKAGE"
Tiger Coaching and Personal Training
Gary Bredehoft
Tiger Fitness & Training Center
2110 Winthrop Rd. Suite 100B
Lincoln, NE 68502
(402)-488-8280
gary@tigercoaching.com
If you have any questions feel free to contact us by email at gary@tigercoaching.com
Name:
Address:
Home Phone:
Work Phone:
Mobile Phone:
Email:
Fax:
Preferred phone consultation day(s) and time(s):
Where and how did you find out about us?
Birthday:
Coaching and Training Information
What type of program are you looking for?
Do you prefer a structured schedule or a more general plan?
Have you and/or will you train with a heart rate monitor?
What is your resting heart rate? (Before getting out of bed)
What is your highest heart rate obtained in recent training and under what conditions?
Approximate training time/schedule and activities currently: and average past 6 months:
Monday:
Tuesday:
Wednesday:
Thursday:
Friday:
Saturday:
Sunday:
Athletic background (if any) include competitive history, number of years, etc.:
Injury problems:
Health problems:
Smoker/Non-Smoker:
Goals: Short Term:
Long Term:
Other comments or requests:
Wavier and Contract
I am fully aware that participating in any exercise program can be a potentially dangerous, hazardous activity. I am specifically aware of the potential dangers of participating in the Tiger coaching and training programs.
In consideration of my acceptance into the Tiger coaching and training program, I, the undersigned (parent or guardian if participant is under 18 years of age) intending to be legally bound, do hereby for myself, my heirs, executors, administrators, and assigns, assume any and all risks of participating in said training programs, and I hereby waive and release any and all rights and claims for damages I may have against Gary Bredehoft, representatives, successors, and assigns for any and all injuries, all such risks being known and appreciated by me. I hereby waive and release the above named persons, and entities, their representatives, employees, successors, and assigns from any and all claims or liabilities of any kind arising out of my participation in said training programs, even though these claims and liabilities might arise out of the negligence or carelessness on the part of the persons named above. I attest and verify that I am physically fit and prepared for the Tiger coaching and training programs, and that a licensed medical doctor has verified my physical condition within the last six months.
I hereby assume full responsibility from any injury, including my death occurring while participating in, or as a result of, my participating in the Tiger coaching and training programs, and hereby release, waive, discharge and covenant not to sue Gary Bredehoft, successors, representatives, employees, assigns, or other participants in the Tiger coaching and training programs from any and all liability to me, my personal representatives heirs, successors, and assigns for any loss or damage and claim or demands therefore on account of injury to me, including my death whether caused by their negligence or carelessness in advising me while participating in the Tiger coaching and training programs.
Signed_____________________________________________Date______________
(Signature of parent of guardian for minor)
I'm ready to try out the Tiger coaching and training program
Signed_____________________________________________Date______________
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