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Registration Form Template

This Registration Form Template allows you to collect registrations in a clear and structured way for events, programs, or online access.

The template includes common registration form fields such as name, email address, professional information, and can be easily customized to fit different registration flows.

This free registration form template helps you manage signups efficiently and reduce manual follow up.

Let's start with your personal details

How young are you?

Please specify gender

What country do you live in?

What are your current goals, and what do you hope to accomplish through 1-on-1 coaching?

Were there any videos that made you interested in 1:1 coaching?

Have you had previous injuries or surgeries related to this area?

What activities do you regularly do?

Online Coaching Agreement, Liability Waiver, and Informed Consent Insider Physical Therapy – 1:1 Coaching

By scheduling, purchasing, or participating in a consultation with Insider Physical Therapy (“Coach,” “Company,” “we,” or “us”), you (“Client”) acknowledge and agree to the following terms:

1. Nature of Services

The services provided by Insider Physical Therapy are educational coaching services related to exercise, movement mechanics, and general physical education.

These services are not medical advice, diagnosis, or treatment and do not establish a physician–patient, therapist–patient, or healthcare provider relationship.

The Client understands that the Coach does not diagnose medical conditions or provide medical treatment.

Clients should consult a licensed healthcare professional before starting any exercise or rehabilitation program.

2. Assumption of Risk

The Client acknowledges that participation in physical activity, exercise, movement instruction, or rehabilitation-style coaching carries inherent risks, including but not limited to:

-Muscle strain

-Joint injury

-Aggravation of existing injuries

-Other unforeseen physical conditions

By participating in coaching sessions or following exercise recommendations, the Client voluntarily assumes full responsibility for any risks associated with these activities.

3. Personal Responsibility

The Client agrees that they are solely responsible for their health decisions, physical condition, and participation in any exercises or recommendations discussed during coaching sessions.

The Client agrees to discontinue any activity that causes pain, discomfort, or injury and seek appropriate medical care if necessary.

4. No Guarantee of Results

While Insider Physical Therapy strives to provide helpful education and guidance, individual results cannot be guaranteed.

Outcomes may vary depending on many factors including but not limited to:

-Individual health conditions

-Adherence to recommendations

-Activity levels

-Previous injuries

5. Payment Policy

All coaching sessions must be paid in full prior to the scheduled appointment.

Failure to complete payment will result in cancellation of the appointment.

6. Cancellation and Refund Policy

Appointments may be cancelled or rescheduled up to 24 hours before the scheduled session.

If cancellation occurs less than 24 hours before the appointment, or if the Client fails to attend the session, the payment will be non-refundable.

7. Privacy and Confidentiality

All coaching sessions are conducted privately.

Insider Physical Therapy agrees not to record, publish, or distribute any part of the consultation on social media or public platforms without explicit written consent from the Client.

Client information will be handled with reasonable confidentiality.

8. Limitation of Liability

To the fullest extent permitted by law, the Client agrees to release and hold harmless Insider Physical Therapy, its owners, employees, and affiliates from any liability, claims, damages, or injuries arising from participation in coaching services or implementation of recommendations discussed during consultations.

9. Governing Law

This agreement shall be governed and interpreted according to the laws of the jurisdiction in which Insider Physical Therapy operates.

10. Agreement and Consent

By booking or participating in a coaching session, the Client acknowledges that they have:

-Read this agreement

-Understood its terms

-Voluntarily agreed to its conditions

11. Virtual Consultation Disclaimer

The Client acknowledges that all consultations are conducted virtually through video conferencing platforms.

The Client understands that virtual coaching may have limitations compared to in-person evaluation, including but not limited to:

-Inability to perform physical examinations

-Limited visibility depending on camera setup

-Reliance on client self-reporting

The Client agrees that Insider Physical Therapy is not responsible for limitations inherent in virtual coaching services.

12. Educational Content Disclaimer

The Client acknowledges that Insider Physical Therapy produces educational content through YouTube and other media platforms.

Any information provided in videos, social media posts, or coaching sessions is intended for educational and informational purposes only and should not be interpreted as medical advice or medical treatment.

Clients should consult a licensed healthcare professional regarding any medical concerns or conditions.

13. Intellectual Property

All materials provided during coaching sessions, including but not limited to:

-Exercise programs

-Movement strategies

-Written recommendations

-Video explanations

are the intellectual property of Insider Physical Therapy.

These materials are intended for personal use only and may not be reproduced, distributed, sold, or shared publicly without written permission from Insider Physical Therapy.

The Client further confirms that they are at least 18 years of age or have permission from a legal guardian

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