DanceKickFit

Client Intake & Goals Form

Personal training intake and participant acknowledgement. Required fields are marked with *.

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Personal Information

Enter the participant’s details below. Guardian details will appear in the next section.

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Referral & Emergency Contact

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Health History & Goals

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Goal Commitment

LeastMost
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Waiver & Release

DanceKickFit© (DKF) Member / Participant Acknowledgement and Assumption of Risk and Full Release from Liability.

The participant acknowledges that physical activities involve the inherent risk of physical injuries or other damages, including but not limited to heart attacks, muscle strains, pulls or tears, broken bones, shin splints, knee, lower back, or foot injuries, and any other illness, soreness, or injury however caused, occurring during or after participation.

The participant further acknowledges that such risks include, but are not limited to, injuries caused by the negligence of an instructor or other person, defective or improperly used equipment, over-exertion, slips and falls, or an unknown health problem. The participant agrees to assume all risks and responsibilities involved with participation and affirms that they are in good physical condition and do not suffer from any disability that would prevent or limit participation.

The participant understands that participation will be physically and mentally challenging and that it is their responsibility to seek competent medical or other professional advice regarding any concerns or questions about their ability to take part. By submitting this form, the participant asserts that they are capable of participating and assumes all responsibility for not exceeding their physical limits.

The participant understands that photos or video may be taken during training and may be used for promotional purposes. DKF will respect written requests not to use a participant's image.

Rescheduling: Should you require rescheduling a session, please let us know before midnight of the day prior to the session or the session will be charged.

↓ Scroll to read the full waiver

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Signature

Date will be stamped automatically: 2026-06-10
Optional measurements (skip if unsure — your trainer can take these at session 1)Show
Privacy

Your information is emailed directly to DanceKickFit and is not stored on this website. Read our privacy notice.

By submitting you agree to the waiver and our privacy notice.