Chair 30mins

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Halligan's Fitness

ABT

ABT 30mins
ABT and Circuit Sessions 2x30mins
ABT and Circuit Sessions 2x30mins
ABT and Resistance Band Session 2x30mins
ABT, Circuit, Circuit and Weights Sessions 4x30mins
ABT Class 30mins and Circuit HIIT Class 30mins
ABT Class 30mins
ABT and Circuit Class 2x30mins
ABT Class 30mins
ABT and Resistance Band Class Sessions 2x30mins

BOXING

Boxing and Circuit Session 2x30mins
Boxing and Circuit Sessions 2x30mins
Boxing and ABT Sessions 2x30mins
Boxing and ABT Class Sessions 2x30mins
Boxing Session 30mins
Boxing and ABT Sessions 2x30mins Sessions 30mins
Boxing and ABT Sessions 2x30mins
Boxing Class Sessions 2x30mins
Boxing Class Sessions 2x30mins
Boxing Class Sessions 2x30mins

CHAIR

Chair 30mins
Chair 30mins
Chair 30mins
Chair 30mins
Chair and Stretch Session 2x30mins
Chair 30mins
Chair 30mins
Chair 30mins
Chair 30mins
Chair 30mins

CIRCUIT

Circuit Sessionsx2 2x30mins
Circuit Session 30mins
Circuit and Weights Sessions 2x30mins

CLUB FIESTA

FRIDAY DISCO

FUNCTIONAL FITNESS

PILATES

RESISTANCE BAND

STRETCH

WEIGHTS

1HOUR WEIGHTS

YOGA

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If an ambulance is ever needed, this is the address we give them.

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Someone we can reach if there's ever an emergency during your session.

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Are you currently exercising?

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Light activity per week (easy walking, gentle yoga, gardening)

None1-2 hrs3-5 hrs6 hrs+

Moderate activity per week (brisk walking, swimming, cycling)

None1-2 hrs3-5 hrs6 hrs+

Vigorous activity per week (running, fitness boxing, HIIT)

None1-2 hrs3-5 hrs6 hrs+

Have you done structured exercise classes before?

YesNo

Now, let's talk about your goals.

Which of these are important to you? Tick as many as you like.

Feel healthierHave more energyImprove strengthMove more easily in daily lifeLose weightRecover from injuryTone upFeel more confident in how I look

Anything else? Other goals or notes

How important are these goals to you right now?

How would you like your trainer to support you?

Tough love? Gentle encouragement? A little of both? Tell us.

Section 1 · Medical safety

Has your medical practitioner ever told you that you have a heart condition, or have you ever suffered a stroke?

YesNo

Do you ever experience unexplained pains or discomfort in your chest at rest or during physical activity/exercise?

YesNo

Do you ever feel faint, dizzy or lose balance during physical activity/exercise?

YesNo

Have you had an asthma attack requiring immediate medical attention at any time over the last 12 months?

YesNo

Are you living with type 1 or 2 diabetes?

YesNo

Section 2 · General health & family history

Do you have a family history of heart disease (e.g. stroke or heart attack)?

YesNo

Have you ever been told that you have high blood pressure?

YesNo

Have you been told that you have high blood sugar (glucose)?

YesNo

Have you ever been told that you have high cholesterol / blood lipids?

YesNo

What is your gender?

FemaleMaleOther / prefer not to say

Section 3 · Lifestyle & injuries

Do you smoke cigarettes on a daily or weekly basis, or have you quit smoking in the last 6 months?

YesNo

Have you spent time in hospital (including day admission) for any condition, illness or injury during the last 12 months?

YesNo

Do you have any diagnosed muscle, bone, tendon, ligament or joint problems that you have been told could be made worse by participating in exercise?

YesNo

Section 4 · Medications & other details

Are you currently taking prescribed medication(s) for any condition(s)?

YesNo

Are you currently pregnant, or have you given birth in the last 6 months?

YesNo

Is there any other information related to your health you'd like to share?

I acknowledge and accept the terms above and wish to participate in the Program.

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Date *

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