For the self guided athlete who likes to have a training plan to help them achieve their goals. This training plan is customized to your life plans, your personal goals and your current fitness level. This is not a generic plan but instead a customized journey.

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Name

First

Last

date of birth

Please describe your typical week of training

Are you beginner, intermediate or advanced

Please describe your fitness goals

Please list any medications or medical issues that may affect your training

Please describe sources of stress or PTSD

Activities & Programs Registering For (Check all that apply)

Personal Training
Custom Training Plan
Endurance Coaching

Your Email

Phone

Permission & Agreement

I agree and give my permission

GENERAL RELEASE OF LIABILITY
Rockhopper Races, LLC
I hereby contract Kristina Folcik of White Mountain Endurance Coaching (Rockhopper Races LLC), as my personal running coach. I agree to pay the agreed upon fee due on the same day of every month for coaching services as agreed upon (weekly 30 minute Zoom meetings plus custom training plan). I understand that ALL services I require are to be billed and paid for up front before I receive said services. Extra video calls are $50 for 30 minutes and can be added at any time.
WAIVER AND RELEASE FROM LIABILITY
In consideration of Rockhopper Races LLC/White Mountain Endurance Coaching for the purposes of improving my fitness, I hereby attest that I am in good health, that my statements in the attached Initial Consultations are accurate to the best of my knowledge, and that my physical condition has been verified by a licensed medical doctor. I fully understand the risk inherent in such a fitness/running program and accept for myself, my heirs, and my personal representatives full responsibility for personal bodily injury, death, or property losses that may occur as a result of my being a part of this program or engaging in training sessions. I hereby indemnify and save and hold harmless my coach Kristina Folcik and Rockhopper Races LLC from any loss, liability, damage and cost I may incur due to my participation in this program. I have read and voluntarily signed this waiver and release from liability, and further agree that no oral representations, statements or inducements apart from the foregoing written agreement have been made.
By accepting these terms I agree to the above Contract and Release from Liability.
If you have any questions, please feel free to contact Coach Kristina Folcik via the website or by email at coaching@kristinafolcik.com
Please retain a copy of this Waiver and Release for your own records.

Weeks	1 month, 12 weeks

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