Registration

Please pop your details in below to register with THRIVE for running coaching & support.

Your details are protected under my privacy policy, and required to help me to best support you.

Please read the terms below and then complete both forms. By signing you are agreeing to these terms.

Eligibility
Clients will be required to complete the proper documentation prior to participation within programme.
Thrive reserves the right to deny services to participants who may not be able to exercise safely within the programme parameters.

First name*

Last name*

Email*

Have you ever had an injury which caused you to stop exercising for more than 1 week? Please describe with dates if possible.

Do you have any other physical or emotional problems which may effect your training?

Are you currently pregnant? *

Yes

Do you currently, or have you ever had any of the following conditions? *

Heart Disease

Heart Attack

Heart Surgery

Heart Murmur

Hypertension

Thyroid Problems

Asthma

Epilepsy

Anemia

Stress Fracture

Diabetes

Eating Disorder

Exercise Addiction

Anxiety or Depression

COVID19

NONE

Other

How far OR How long was your longest recent run in the last 4 weeks? Please specify if if your answer is in km, miles or minutes!

What days/How many days each week are you available to train?

Does your schedule vary or is it fairly consistent?

What time of day do you have most energy?

List your top 3 running strengths

List your top 3 running weaknesses

How competitive are you? 1 star being not very, 5 stars being super competitive.

How much do you enjoy the intensity of a race? 1 star being not at all, 5 stars being love it!

How confident are you in your abilities as a runner? 1 star being not at all, 5 stars being very confident.

Do you like to be challenged? 1 star being not at all, 5 stars being very much so.

Do you look forward to hard training sessions? 1 star being not at all, 5 stars being very much so.

Are you susceptible to mental burnout? 1 star being not at all, 5 stars being very much so.

Will you be training by yourself or with others?

myself

with others

a mixture

Do you do any Strength Work ?

Yes

If YES to above, please specify

What are your short term goals (0-4 weeks)

What are your medium term goals (0-12 weeks)

What are your long term goals (beyond 12 weeks)

Why, When and How did you get started in running?

What prompted you to enquire about coaching?

Is there anything else you think I should know?

I have stated all of my known medical conditions, in confidence and agree to keep Jill Fairbairn updated on any health issues which may arise. I consent to accept full responsibility for my participation with Thrive Running.

Signature

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Date

Day

Month

Year

THRIVE Registration Form

Physical Activity Readiness Questionnaire

First name*

Last name*

Email*

Phone

Has your doctor ever said that you have a heart condition and that you should only do physical activity recommended by a doctor?*

Yes

Do you feel pain in your chest when you do physical activity?*

Yes

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

Yes

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

Yes

Do you have a bone or joint problem (for example, back, knee or hip) that could be made worse by a change in physical activity?*

Yes

Is your doctor currently prescribing drugs (for example, water pills) for your blood pressure or heart condition?*

Yes

Do you know of any other reason why you should not do physical activity?*

Yes

If you have answered YES to any of the above questions, then it is important that you gain consent from your doctor before participating in any running/strength session.