Crossfit Deer Park Group Training Policies And Liability Release Page 5

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How much water do you drink a day?
Expectations
Specifically describe what you would like to accomplish through your fitness program during the next:
1 month:
6 months:
1 year:
Exercise History and Attitude Questionnaire
1. Please rate your exercise level on a scale of 1 to 5 (5 indicating very high)
Years old: 15-20 21-30 31-40 41-50 51-60 60+
2. Where you a high school and/or college athlete?
_ YES _ NO - If yes, please specify:
3. Do you have any negative feeling toward, or have you had any bad experiences with physical activity programs?
_ YES _ NO - If yes, please explain:
4. Do you have any negative feelings toward, or have you had any bad experiences with fitness testing and
evaluation?
_ YES _ NO - If yes, please explain:
5. Rate yourself on a scale 1 to 5 (5 indicating very high). Circle the number that best applies.
Characterize your present athletic ability:
1 2 3 4 5
When you exercise, how important is competition?
1 2 3 4 5
Characterize your present muscular capacity:
1 2 3 4 5
Characterize your present flexibility capacity:
1 2 3 4 5

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