Before Your First Session

Health & Activity Readiness Form

This form is for anyone booking private coaching with me directly (separate from Swinley Bike Hub's own registration). Mountain biking and coaching sessions involve physical exertion, and this short form helps make sure sessions are planned safely around your health — please complete it before your first booking.

Your Details

Full Name Date of Birth Email Phone Number Emergency Contact (name and phone number)

Health Screening

Please answer honestly — a "yes" answer doesn't necessarily mean you can't take part, it just means we may check with your GP first to make sure sessions are planned safely.

1. Has a doctor ever told you that you have a heart condition, or that you should only do physical activity recommended by a doctor?

Yes No

2. Do you feel pain or discomfort in your chest during physical activity?

Yes No

3. In the past month, have you had chest pain when you were not doing physical activity?

Yes No

4. Do you lose your balance due to dizziness, or have you lost consciousness (including from a concussion) in the past 12 months?

Yes No

5. Do you have a bone, joint, or soft tissue problem that could be made worse by a change in your physical activity?

Yes No

6. Is your doctor currently prescribing medication for blood pressure or a heart condition?

Yes No

7. Are you aware of any other reason why you should be cautious about taking part in physical activity?

Yes No

If you answered "Yes" to any question above, or have any other health information Mary Ann should know, please give details here: Your GP / Doctor's Surgery (name and phone number, if known)

I confirm the information given above is accurate to the best of my knowledge, and I understand it will be used solely to help plan my coaching sessions safely.

I understand mountain biking carries an inherent risk of injury, and I have read and agree to the Terms & Liability page.