Zoom 60 Participant Information Form

Welcome to Zoom-60

To ensure that you have the best experience with us, please take a few moments to answer the following questions prior to your first class. All information will be kept private and confidential.

Question Title

* 1. Please provide the street address where you will be during our Zoom class. This is a safety precaution for emergencies only.

Full Name *

Address *

Address 2

City/Town *

Province *

Postal Code *

Country *

Email Address *

Phone Number *

Question Title

* 2. Do you consent to receiving emails from Tanya Miller Personal Training and Peaceful Panda Yoga? This will include reminder emails for your classes and occasional promotional info about future classes. You can unsubscribe at anytime.

Yes

Question Title

* 3. Approximately how many minutes per week are you physically active at this time?

Question Title

* 4. What types of activities do you currently enjoy?

yoga/meditation

Pilates

walking/hiking

running

biking

resistance training

group sports

Netflix

Other

Question Title

* 5. Please describe your previous experience with practicing yoga and meditation?
Please also describe your previous experience with resistance training, personal training or other forms of fitness training.
(no previous experience is ok too!)

Question Title

* 6. What are your expectations for this class?

fun workout and yoga with friends

motivation to get you moving

increase in muscle/strength/flexibility

Stress reduction

Other

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* 7. What equipment do you have access to?

dumbbells

kettle bells

bands

swiss/physio ball

yoga blocks

yoga strap

mat

Other

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* 8. Please review the waiver link for yoga. I have read and agree to the waiver. Link to Waiver

YES

Question Title

* 9. Have you completed the attached Physical Activity Readiness Questionnaire for Everyone (PAR-Q+)? PAR-Q+ Link

YES

Question Title

* 10. Based on the PAR-Q is it necessary for you to seek further advice before becoming more physically active?

YES

Zoom 60 Participant Information Form

Welcome to Zoom-60

Question Title

* 1. Please provide the street address where you will be during our Zoom class. This is a safety precaution for emergencies only.

Question Title

* 2. Do you consent to receiving emails from Tanya Miller Personal Training and Peaceful Panda Yoga? This will include reminder emails for your classes and occasional promotional info about future classes. You can unsubscribe at anytime.

Question Title

* 3. Approximately how many minutes per week are you physically active at this time?

Question Title

* 4. What types of activities do you currently enjoy?

Question Title

* 5. Please describe your previous experience with practicing yoga and meditation? Please also describe your previous experience with resistance training, personal training or other forms of fitness training. (no previous experience is ok too!)

Question Title

* 6. What are your expectations for this class?

Question Title

* 7. What equipment do you have access to?

Question Title

* 8. Please review the waiver link for yoga. I have read and agree to the waiver. Link to Waiver

Question Title

* 9. Have you completed the attached Physical Activity Readiness Questionnaire for Everyone (PAR-Q+)? PAR-Q+ Link

Question Title

* 10. Based on the PAR-Q is it necessary for you to seek further advice before becoming more physically active?

* 5. Please describe your previous experience with practicing yoga and meditation?
Please also describe your previous experience with resistance training, personal training or other forms of fitness training.
(no previous experience is ok too!)