TOC PHYSICAL READINESS FORM & WAIVER After filling out some initial paperwork (Lifestyle questionaire, PAR-Q and liability waiver) and chatting with me via email or telephone, you will receive a customized exercise program, including strength, cardiovascular and flexibility training within 72 hours. Consult a physician before commencing any new physical activity, especially if you are over 68 years of age or you answer "YES" to any of the following questions. Has your doctor eversaid that you have a heart condition and that you should only do physical activityrecommended by a doctor? * Yes No Do you feel pain in your chest when you do physical activity? * Yes No In the past month, have you had chest pain when you were not doing physical activity? * Yes No Do you lose your balance because of dizziness or do you ever lose consciousness? * Yes No Do you have a bone or joint problem (for example: back, knee, hip) that could be made worse by physical activity? * Yes No Is your doctor currently prescribing drugs for your blood pressure or heart condition? * Yes No Do you know of any other reason why you should not do physical activity?