Training Camp Mallorca
Booking Form & Questionnaire
Thank you for signing up to one of our training camps!
The next step is to take a few minutes to complete your details below and answer some basic health questions. This will enable us to plan a safe and effective programme for you. It’s also essential that we know about any existing medical conditions or injuries. Postal address for completed forms is: Tiree Fitness, Sandaig, Isle of Tiree, PA77 6XQ
Also, we’d love to know any specific targets and goals you are working on. The camp is here to help you get the very best from yourself. There is space at the end where you can include any additional information. Many thanks and we look forward to seeing you soon.
Personal Details Name: Address: Telephone: Email: Date of birth:
Emergency Contact Name: Address: Telephone: Relationship to you:
Bike sizing and team kit Road bike frame size if known: Your height: Any pedal requirements (Shimano, Look, Crank Bros etc): Training Camp T-Shirt size (S,M,L,XL):
Other information: Please let us know any allergies or special dietary requirements you have:
Prices are based on sharing a twin room, would you prefer a single room (£50 supplement applies): Health and Activity History
1. How would you describe your current level of fitness and how active are you during a typical week?
2. What would you most like to achieve through coming on a training camp?
3. Do you have any long-term goals you’re working on that we can help with on the camp?
4. What is the most appealing aspect of coming on a Mallorca training camp?
5. Please tell us if there any activities, exercises or movements that cause you pain or you are particularly uncomfortable with?
6. Do you have any medical conditions or injuries or any medication you are taking? If so please give details.
Physical Activity Readiness Questionnaire:
Do you have, or have you ever had any of the following? Please circle answers if completing paper copy or amend as appropriate if completing electronically (if you answer yes to any, please provide brief details and last occurrence):
History of heart problems, chest pains or stroke Yes / No Increased blood pressure or low blood pressure Yes / No Any chronic illness or condition Yes / No Recent surgery in last 12 months Yes / No Pregnancy now or in last 6 months Yes / No History of breathing or lung problems Yes / No Muscle, joint or back disorder Yes / No Any previous injury affecting you Yes / No Diabetes or thyroid condition Yes / No
Acknowledgement (the serious bit): I declare that I have completed this questionnaire fully and honestly and I will inform my instructors if there are any changes in my circumstances. I am aware and understand the potential risks and dangers associated with physical activity and the use of training equipment, especially in an outdoor environment where unforeseen hazards and external factors are abundant. I have had the opportunity to ask questions about the camp activities and any questions I have asked have been answered to my satisfaction. By signing this form I accept the risks associated with physical activity and understand that at all times it is my own responsibility to ensure that I am participating within my ability level. Tiree Fitness and the instructors accept no liability for any injury, illness or death resulting from my participation in this training camp.
Name: Signature: Date:
Further questions:
If you have any queries about this form, any concerns, special requirements etc, please do not hesitate to contact us using the details below.
Once we have received your completed form and the relevant payment we will contact you to confirm your place on the camp and give you instructions on what to do next.
Happy Training!
Will Wright Tel: 01879 220 421 Mob: 07867 304 640 Email: [email protected]