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Parental Consent & Waiver

Our Parental Consent & Waiver is required to be completed on behalf of any minor school age athlete under the age of 18 looking to receive fitness coaching services under Starr Fit Club. It is the responsibility of each individual parent/legal guardian to ensure completion and submission of the form prior to the start of coaching to confirm a start date and to adhere to the consent and use of our services. Complete/submit the form below prior to the 1st session.

PARENTAL CONSENT & WAIVER

Complete/submit the required Starr Fit Club fitness coaching "Parental Consent & Waiver" form below. Parents/legal guardians must also ensure completing the required "Fitness Coaching Agreement" alongside this form prior to the start of a 1st session which will be provided once agreement is signed, submitted, and payment is made.

*First name

*Last name

*Email

*Phone

Emergency Contact Name

Relationship To You

Emergency Contact Phone

How did you hear about "Starr Fit Club"?

*We'd love to know!

About Your Teen Athlete

Is the teen athlete currently in "Good Standard Health" to exercise?

Provide your opinion

What is the teen athlete's "Fitness Experience?

*Tell us where they are

What is the "Primary Goal" of your teen athlete with fitness coaching?

*Select the specific goal

What's your teen athlete's "Specific Focus" in a exercise program?

*Select a program specific focus

Parent/Legal Guardian Choice

Is there anything you can contribute about your teen we should know?

*Behavior(s) or habits, temperament, personality, work ethic, etc..

Yes, I'd be happy to elaborate

No, nothing I can think of

*Elaborate any details (if any) if none, say "None"

Teen Athlete Health History

Has a physician recommend fitness coaching for your teen athlete?

*choose one

Yes

Has a physician ever advised against exercise for your teen athlete?

*Choose one

Yes

Has the teen athlete been diagnosed with any heart conditions?

*Multi choice

Yes

Has the teen athlete been diagnosed with asthma or other condition?

*Choose one

Yes

Are there any areas of the body formerly compromised by prior injury?

*Multi choice

Yes

*Select the area of the body (if any) if none select "None"

List all medications your teen athlete is currently taking, and reason?

*List all medications, and reasons (if any) if none, say "None"

List all past or recent injuries, surgeries, or accidents?

*List all with year (if any) if none, say "None"

List all conditions your teen had medical treatment for in the past year?

*List all conditions and hospitalization (if any) if none, say "None"

Parental Waiver of Liability

I release the fitness coach trainer and Starr Fit Club of all liability for any harm to my teen athlete or any complications that may unintentionally occur during or after my their fitness coaching to include, pain of any kind, or any side effects that may develop as a result of exercise program sessions.

Informed Consent Agreement

I acknowledge and agree that fitness coaching is NOT a substitute for any medical care or any physical therapy for the minor registering and that it is recommended that I work with our family primary caregiver for any condition(s) my teen athlete may have or develop while receiving fitness coaching.

I acknowledge that I am the legal parent or guardian of the teen minor athlete named on this form and that my teen has expressed his/her personal interest in fitness exercise program, therefore I am giving consent on their behalf for them to receive exercise programming from fitness coach of Starr Fit Club.

I understand there will be no refunds if I or the teen minor athlete changes their mind after the first week of starting fitness coaching sessions.

I agree as the parent/legal guardian to responsibly ensure the completion and submission of the required "Fitness Coaching Agreement" to ensure my teen minor athlete will be able to receive fitness coaching.

I further understand that if the agreement is not submitted in a timely manor I am not guaranteed to any set coaching dates as they may be taken up by other clients.

I acknowledge that my teen athlete is free of COVID-19, seasonal flu, or other contagious conditions.

www.myhealinghandsmassage.com/starrfitterms-conditions I have read and agree to Starr Fit Club Terms, Conditions, and Privacy Policy.

*Sign Here

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