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Intake Form

How did you hear about us?

By signing this document, I acknowledge the inherent risks and voluntarily assume full responsibility for any injury, damage, or loss that may result from my participation. I hereby waive and release the business, its owners, and its staff from any and all liability, past, present, and future, relating to the services provided.


Additionally:

I understand that all information I entered in this form will be considered strictly confidential.


The data gathered from this form will only be used as a basis for the type of coaching the client will need.


I understand that in order to be successful, it is vital to follow the plan agreed to by both the coach and myself (the client).

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