You are here: Home / Online Registration

Online Registration

Please complete the following Individual Conditioning Agreement

First Name
Last Name
Street Address
City
Province
Postal Code
Country
Phone Number
Email Address
Sport
Team
Level
Position
Shoots
Throws
Gender Male Female 
Height

Weight

 lbs

Age
Select Program

  • Excel Fitness Inc. will administer a strength and conditioning program for the athlete named above
  • Once appointments are confirmed, a minimum of 24 hours is required to change or cancel. No show appointments are charged 100%

Physical Activity Readiness Questionnaire: Please select appropriate answer. (REQUIRED)

  1. Do you or have you ever experienced chest pain, shortness of breath, pain in upper extremity as a result of physical activity?
    Yes No 
  2. Have you ever been diagnosed with high blood pressure, heart disease, risk factor for stroke or stress related conditions?
    Yes No 
  3. Has your doctor ever advised you to not participate in any sports, exercise program, or recreational activity as a result of the above conditions?
    Yes No 
  4. Do you have any neuromuscular conditions that prevent you from participating in sports or exercise programs?
    Yes No 
  5. Have you had any injuries or conditions, chronic or acute, that currently prevent you from participating in sports or an exercise program (ex. fractures, sprains, concussions)?
    Yes No 
  6. Is there any other medical reason that does not allow you to participate in this or certain aspects of any exercise program or conditioning camp?
    Yes No 
    If yes please advise:

WAIVER:
I certify that I am cognizant of the inherent dangers and risks associated with all sports. I agree that I shall provide health insurance or other applicable insurance to cover any personal injury or property damage sustained by the applicant while participating in Excel Fitness Inc. programs, and ensure the applicants equipment is in good working order. In consideration of the applicants participation in this training program, the applicant agrees that Scott Hebert, Excel Fitness Inc., it's proprietors, employees, and participants will not be responsible for any accident or loss, injury, or death, however caused. I hereby release Excel Fitness Inc and its employees from all claims, liability, or damages, which may arise as a result of such accident or loss.

WAIVER CONFIRMATION:
BY CHECKING THE AGREE BOX, I CONFIRM THAT I HAVE READ, UNDERSTOOD AND AGREE TO THE ABOVE WAIVER. I AGREE:

********************************************
Enter the Security Code below into the box, then submit.
To use CAPTCHA, you need Really Simple CAPTCHA plugin installed.


NOTE: If button not active, you need to AGREE to WAIVER CONFIRMATION first.