Get Started

To begin working toward your triathlon goals, please fill out the following questionnaire. One of our certified triathlon coaches will contact you within the next 48 hours to discuss our coaching options. For general questions about our services, please contact James Rudd at 404.432.6204

Endurance Concepts New Athlete Questionnaire
  1. Athlete Contact Information
  2. (required)
  3. (required)
  4. (required)
  5. (required)
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  7. (required)
  8. (required)
  9. (valid email required)
  10. Emergency Contact Information
  11. (required)
  12. (required)
  13. Biographical Data
  14. (required)
  15. (required)
  16. (required)
  17. Goals and Expectations
  21. Personal Health History
  27. Has your doctor ever said you have heart trouble?

  29. Do you ever get chest pain?

  31. Do you often feel dizzy or faint?

  33. Has a doctor ever told you your blood pressure is too high?

  35. Has a doctor ever told you that you have a bone or joint condition which could be made worse with exercise?

  37. Are you accustomed to regular vigorous exercise?

  39. Is there a physical reason not mentioned here why you should not follow an active exercise program even if you wanted to?

  41. Has your doctor given you any indication that you should not participate in any physical activity?

  43. Informed Consent and Disclosure Form

  44. By his/her signature below, the undersigned acknowledges & agrees with the members, contractors, managers, agents and employees of James Rudd, dba Endurance Concepts, LLC (“Endurance Concepts”) as follows:

    1. In order to more safely engage in an exercise program, the undersigned hereby voluntarily consents to exercise testing by Endurance Concepts. Customarily, these tests may include skinfold measurements, strength tests, endurance tests, flexibility tests, and such other tests which Endurance Concepts believes in good faith should be administered to the undersigned (the “Testing”). The undersigned consents to the performance of the Testing with the understanding that the Testing subjects the undersigned to the risk of injury to person and property as more fully disclosed below and, to varying degrees, the Testing may involve contact with the undersigned’s body. To the extent that the undersigned has concerns about these potential contacts, the undersigned must immediately advise Endurance Concepts so that Testing can be explained in detail. To the extent that the undersigned fails to request an explanation or agrees to the Testing after a requested explanation, the undersigned will be deemed to have authorized and agreed to such contact with his or her body. During the Testing, exercise will begin at low exertion levels and will increase in stages. Either Endurance Concepts or the undersigned may stop the Testing at any time because of signs of fatigue or any other reason.

    2. Endurance Concepts will assume that the undersigned is in good health and does not suffer from any health issue, illness or medical condition that could be triggered or aggravated by the Testing or by any exercise program recommended by Endurance Concepts. To the extent that the undersigned is aware of any personal health issues, illnesses or medical conditions, the undersigned must disclose them in detail in writing on the back hereof. To the extent that the undersigned fails to provide such written disclosures to Endurance Concepts on the back hereof, Endurance Concepts’ ability to determine appropriate and safe Testing will be adversely affected and the risk of injury to person or property will be materially increased.

    3. The undersigned understands that the testing includes an inherent risk of injury to person and property and the undersigned assumes all risks associated with the Testing by Endurance Concepts and with any exercise recommended by Endurance Concepts including, but not limited to, heart beat disorders, abnormal blood pressure response, strokes, heat stress, sprains, broken bones, torn muscles and ligaments, very rarely, heart attack, and, very rarely, death. On behalf of him or her, and his or her heirs and assigns, the undersigned knowingly releases and discharges Endurance Concepts from any responsibility whatsoever, to the fullest extent permitted by law, for any injury or damage to person or property sustained by reason of the Testing or of any exercise program recommended by Endurance Concepts and for the costs of defense including attorneys’ fees (the “Released Claims”). On behalf of him or her, and his or her heirs and assigns, the undersigned further agrees to indemnify and hold harmless Endurance Concepts from the Released Claims.

    4. The undersigned desires such Testing so that he or she can engage in a more effective personalized exercise program, but the undersigned understands that the Testing does not eliminate the risk of injury to person or property in the execution of any exercise program recommended by Endurance Concepts.

    5. The undersigned understands and agrees that information from the testing may be used for reports and research publications as long as their name and mailing address are not be disclosed.

    6. The undersigned understands that he or she can discontinue participation in any aspect of the Testing or any exercise program recommended by Endurance Concepts at any time without penalty.

    7. The undersigned consents and agrees that Endurance Concepts may administer emergency care to me and my guests and any member of my family in the event of a medical emergency.

    8. I have read the statements above and have had all of my questions answered to my satisfaction.

  45. (required)
  46. (required)
  47. Waiver
    By participating in physical training and racing activities, I acknowledge and accept and assume the
    risk inherent therein. I certify that I am physically fit and have not been advised against participation by
    a qualified professional. I WAIVE, RELEASE, AND DISCHARGE from any and all claims, loses or liabilities for death, personal injury, partial or permanent disability, property damage, medical or hospital bill, theft, or damage of any kind, including economic losses, which may in the future arise out of or relate to my participation in the training programs discussed above or racing activities directed by James Rudd, dba Endurance Concepts, LLC (“Endurance Concepts”), and all contractors and /or associates.
    THIS RELEASE INCLUDES CLAIMS, LOSSES, OR LIABILITIES ARE CAUSED OR CLAIMS TO BE
    THE RESULT OF THE NEGLIGENT ACTS OR OMISSIONS OF THE PERSONS I AM RELEASING
    OR ARE CAUSED BY THE NEGLIGENT ACTS OF OMISSIONS OF THE PERSONS I AM
    RELEASING OR ARE CAUSED BY THE NEGLIGENT ACTS OR OMISSIONS OF ANY OTHER
    PERSON OR ENTITY.
    I assume the risks of running, biking, swimming, and resistance training, or the participation in any racing or training event. I also assume any and all other risks associated with the training program or racing activities, including but not limited to falls, or effect of any other participants, effects or weather, including heat and /or humidity, defective equipment, the condition of roadways, water hazards, contact with other participants, and any hazard that may be posed by vehicular traffic or pedestrians, all such risk being known and appreciated by me. I further acknowledge that these risks that may be the result of the negligence of the persons released herein. I agree to indemnify and hold harmless the persons released herein from any and all claims made or liabilities assessed against them as a result of my actions or inactions, the actions of negligence of others, including those parties hereby indemnified or any other harm caused by an occurrence related to Endurance Concepts’ training programs and activities.
    It is further understood that this waiver, release and assumption of risk is to be binding on my heirs and assigns.
    I affirm that I am eighteen (18) years of age or older. I have read, understand and agree to the terms of
    the above waiver.
  48. (required)
  49. (required)
  50. Signature of parent of legal guardian if athlete is under the age of 18 years old.
 

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