The PaperWork Welcome Athlete!Please complete the paperwork below and click submit so Run Coach Kai can start schedule your class and/or designing your training program. Service Agreement The Running Form Class Series Individual Training Program Group Training Program General Name * First Name Last Name Sex * Female Male Height * 4' 6" 4' 7" 4' 8" 4' 9" 4" 10" 4' 11" 5' 5' 1" 5' 2" 5' 3" 5' 4" 5' 5" 5' 6" 5' 7" 5' 8" 5' 9" 5' 10" 5' 11" 6' 6' 1" 6' 2" 6' 3" 6' 4" 6' 5" 6' 6" 6' 7" 6' 8" 6' 9" 6' 10" 6' 11" 7' 7' 1" 7' 2" 7' 3" 7' 4" 7' 5" Birthday * MM DD YYYY How did you hear about training with Coach Kai? Internet Search Instagram Facebook Yelp Facebook A recommendation from someone Contact Email * Phone * (###) ### #### Mailing Address Address 1 Address 2 City State/Province Zip/Postal Code Country Emergency Contact Name * First Name Last Name Emergency Contact Phone * (###) ### #### Health Were you previously or are you currently injured? * Yes No If so, what is the injury? As of today, are you cleared by a health professional to exercise? * Yes No Running How long have you been running? * 1 year 2 years 3 years 4 years 5 to 10 years 10+ years I have not been running About how many miles per week did you run did run this past month? 5 10 15 20 25 30 35 40 45 50 55 60 65 70 75+ About how many days per week did you run this past month? 1 2 3 4 5 6 7 In miles, what was your longest run this past month? 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 What type of cross-training do you do? (check all that applies) Aqua Running Cross-Country Skiing Cycling Elliptical Mixed Martial Arts Pilates Strength Training Swimming Yoga Other Training goal - what are you trying to accomplish and by when? * Have you ever been coached? * Yes No If yes, what did you like or dislike? * Which day(s) you cannot workout * Monday Tuesday Wednesday Thursday Friday Saturday Sunday Personal Bests In order to ensure that your training metrics like paces are as accurate as possible, please enter your best 5K (3.1 miles) or 10K (6.2 miles) time below. Mile 5K 10K Half Marathon Marathon Waiver of Liability, Assumption of Risk, and Indemnity Agreement * Waiver: In consideration of being permitted to participate in Coach Kai LLC’s training program I, for myself, my heirs, personal representatives and assigns, do hereby release, waive, covenant not to sue and discharge Coach Kai LLC from liability from any and all claims including the negligence of Coach Kai LLC resulting in personal injury, accidents or illnesses (including death), and property loss arising from, but not limited to, participation in training programs. Assumption of Risks: Participation in running and conditioning programs carries with it certain inherent risks that cannot be eliminated regardless of the care taken to avoid injuries. I know that running is a potentially hazardous activity and certify that I am in good health and physically fit to enter into a training program. I acknowledge that I am aware of the many risks involved in athletic training in general and running training specifically, which risks include by way of example and not limitation: 1) minor injuries such as scrapes, bruises, sprains and strains, 2) more serious injuries such as joint, muscle and bone injuries, concussions and other head injuries, heat related injuries such as heat stroke and heat exhaustion, dehydration and over hydration conditions such as hyponatremia, and catastrophic injuries and conditions such as heart attacks and other conditions or injuries which could be fatal. I have read the previous paragraphs and I know, understand, and appreciate these and other risks that are inherent in training for and participating in road, trail and track running and racing and any conditioning and cross training activities associated with that training. I hereby assert that my participation is voluntary and that I knowingly assume all such risks. Indemnification and Hold Harmless: I also agree to INDEMNIFY AND HOLD HARMLESS Coach Kai LLC from any and all claims, actions, suits, procedures, costs, expenses, damages and liabilities, including attorney’s fees brought as a result of my involvement in Coach Kai LLC’s training program Severability: The undersigned further expressly agrees that the foregoing waiver and assumption of risks agreement is intended to be as broad and inclusive as is permitted by the law of the State of New York and that if any portion thereof is held invalid, it is agreed that the balance shall, notwithstanding, continue in full legal force and effect. Acknowledgment of Understanding: I have read this waiver of liability, assumption of risk, and indemnity agreement consisting of two pages, fully understand its terms, and I understand that I am giving up substantial rights, including my right to sue. I acknowledge that I am signing the agreement freely and voluntarily, and intend by checkbox below to be a complete and unconditional release of all liability to the greatest extent allowed by law Yes, I agree to the Waiver of Liability, Assumption of Risk, and Indemnity Agreement Thank you!
