Welcome To Get Fit NH Concord
You have made a great decision to come to Get Fit NH. We look forward to helping you achieve the best version of you! 

Cr8 Health & Fitness, LLC/Get Fit NH is committed to protecting your privacy. We do not sell, trade or rent your personal information to others. Your confidentiality is very important to us, and information collected is used solely to allow us to serve you better.
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General Information

 
First Name *

 
Last Name *

 
Street Address *

 
City *

 
State *

 
Zip Code *

 
Cell Phone # *

 
Emergency Contact and Phone Number *

 
Birth Date *

 
Profession *

 
Is this the first time you have trained with Get Fit NH?


 
How did you hear about us? *


 
I was referred by

 
Fitness Level (1-10); 10 being "Most Fit" *

 
What are your goals and expectations for joining our training program? *

 
Choose Your Training Time *


 
Health & Medical History

Please Answer All Questions. If you have been with us before, please update any changes to your health status.
 
Has a physician ever said you have a heart condition and should only do physical activity recommended by a physician? *

     
 
When you do physical activity, do you feel pain in your chest? *

     
 
When you were not doing physical activity, have you had chest pain in the past month? *

     
 
Are you 55 years of age or older? *

     
 
Is there a history of heart disease (prior to age 55) in your immediate family? *

     
 
If Yes, please explain

 
Do you ever lose consciousness or do you lose your balance because of dizziness? *

     
 
Do you have high blood pressure? *

     
 
Is a physician currently prescribing medications for your blood pressure or heart condition? *

     
 
Do you have a joint or bone problem that may be made worse by a change in your physical activity? *

     
 
If Yes, please describe

 
Are you pregnant, or have you been pregnant within the last 3 months? *

     
 
Have you had major or minor surgery in the last 3 months? *

     
 
If Yes, please explain

 
Have you been hospitalized in the last 2 years? *

     
 
If Yes, please explain

 
Do you have Type I or Type II diabetes? *

     
 
Are you allergic to any medication (aspirin, penicillin, sulfa, etc.)? *

     
 
If Yes, please explain

 
Do you take any prescribed medications on a permanent or semi-permanent basis? *

     
 
If Yes, please explain

 
Have you ever been found to be anemic (low blood count) *

     
 
Do you have asthma? *

     
 
Have you ever injured your back or neck? *

     
 
Do you have back pain? *

     
 
If Yes, please describe location and frequency

 
Do you have any other physical conditions which cause pain (knee, hip, shoulder, etc.)? *

     
 
If Yes, please describe

 
Do you receive regular physical exams from your primary care physician? *

     
 
Physician Name

 
Physician Phone

 
What was the date of your last exam?

 
Do you have any additional health, medical or injury conditions or history (cancer, migraine, head injury, seizure, other)? *

     
 
If Yes, please describe

 
Do you know of any other reason you should not exercise or increase your physical activity? *

     
 
Approval of Health & Medical History *

I certify that I understand the forgoing questions and my answers are true and complete. I also understand that if this information changes in any way in the future, it is my responsibility to notify my trainer, and that I assume the risk for any changes in my medical condition that might affect my ability to exercise. 

I acknowledge that it is recommended to consult a physician prior to starting any health/fitness/nutrition program, and that only a qualified health care provider is able to diagnose and prescribe treatment for specific health conditions. If I choose not to obtain a physician's consent, I hereby agree I am doing so solely at my own risk.

I agree to the above statement
     
 
Training Agreement

We want everyone who participates in our training programs to have fun, be committed to the process, and achieve results. We want you to be so thrilled with your experience that you will want to come back, and bring your friends and family with you.
 
I agree to show up for training on time every day I have signed up for unless I have notified my coach in advance or I have an excused absence from my doctor. *

     
 
I understand that I may appear in images or video relating to my participation in training and events, and give full permission to Cr8 Health & Fitness, LLC to use these royalty-free in advertisements, promotions or commercials. *

     
 
I agree to confidentiality with respect to services provided by Get Fit NH. I further agree that I will not engage directly or indirectly in the outdoor fitness or boot camp fitness business within a 30 mile radius of any Get Fit NH *

     
 
I understand there is no cash refund policy, but credit toward another training may be applied if I am unable to continue due to circumstances beyond my control. I further understand that no credit may be applied to any other services Cr8 Health & Fitness, LLC may offer. *

     
 
I understand that diet and nutrition habits directly affects my performance and fitness results *

     
 
I further agree to bring a positive attitude, use my strengths to help others training, respect all other participants, embrace challenges, and most importantly, be prepared to have fun! *

     
 
Have you completed, signed and agreed to the Waiver of Liability, Indemnity Agreement and Assumption of Risk form with Cr8 Health & Fitness. LLC/Get Fit NH? *

     
 
Digital Signature *

By typing your name into this field, you are hereby providing a digital signature.

Please Type Your Name
 
Date Submitted

Thank-You for filling out and submitting your registration form. We will call you ASAP and get this party started!
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