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Pre Training Questionnaire

Contact Details

Please fill in your contact details.

Firstname:*
Surname:*
Phone - Mobile:*
Email:*
Date of Birth:* Day Month Year
Gender:*
Street Home:*
City/Suburb:*
State:*
Postcode:*
Q 1: Which area / time best suits you?*

All groups start at 6am (Mon - Fri) unless otherwise stated.
Q 2: Briefly describe your current exercise regime:
Q 3: Do you know anyone who trains with Evolution Outdoors already?
[1]
[2]
[3]
[4]
Q 4: Who are you bringing with you? (option to provide us with their name and number or email address and we will invite them along)
Q 5: Have you ever suffered from or currently have any of the following?
High Blood Pressure >140/90
High Cholesterol/triglycerides
Arthritis
Any heart/stroke condition
Asthma
Diabetes
Stomach/Duodenal Ulcer
Liver/Kidney Condition
Exercise induced asthma
Allergy induced asthma
Q 6: Are you on any medication? If so what.
Q 7: Do you have any allergies?
Q 8: Is there anything else you want to tell us that might affect your ability to participate?
Q 9: I understand that I am responsible for my own participation in any activities undergone in Evolution to Wellbeing classes or associated classes. I have answered all questions regarding any medical history and recent medical treatments received by me and will continue to inform Evolution to Wellbeing of any information which will affect my health and wellbeing in regard to my participation in any program. *
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