The Performance Club Questionnaire

General info

What is your name?*

What is your email?*

What is your phone number?*

What is your gender?

What is your date of birth?

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Injury history

Do you currently have any injuries, knocks or niggles?

Yes

Have you had any previous surgeries?

Yes

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Current medication

Medical history/conditions

Allergies

Please detail as much information as possible on any previous injuries in:

2025

2024

2023

Pre-2023

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Activity questions

How many times do you train per week?

What time do you usually train?

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Subjective performance

What are your biggest athletic / physical strengths?

What are your biggest athletic / physical weaknesses?

What sport specific skills do you want to improve on?

How do you think we can help, and what do you most want to get out of signing up with us?

Is there any other information that you want to provide?

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Exercise risk awareness waiver form

Yes

I am voluntarily choosing to participate in any prescribed exercise and acknowledge that it comes with a risk of injury and/or illness.

Yes

I understand that every effort is made by KPI to prevent and protect me as an athlete from any form of injury or illness.

Yes

I am aware that injuries may include, but are not limited to, heart problems, muscle strains, ligament sprains, bone fracture or complete break, or any other illness or soreness, including death.

Yes

I agree to assume full responsibility for any risks, injuries, or damage which I may incur as a result of or related to any of the prescribed exercise.

Yes

I agree to concede full responsibility for any financial expenses which may incur as a result or related to any injuries or damage related to any of the prescribed exercise.

Yes

I have read the above waiver and release of liability and fully understand its contents. I voluntarily agree to the terms and conditions stated above.

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Non-disclosure agreement

I agree

By submitting this form, you agree to be bound by these Terms & Conditions. If you do not agree with any part of these terms, you must not use our services.

If you're struggling to submit this form please make sure you've filled out all mandatory fields on all pages

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