Health Screening & Waiver · Unbroken Protocol

01 About you

The basics.

First name *

Last name *

Date of birth *

Phone *

Email *

Emergency contact · name *

Emergency contact · phone *

GP name & surgery (optional but recommended)

02 PAR-Q+ · Pre-participation screening

The seven health questions.

Answer each honestly. If you're unsure, answer yes and add a note — we'd rather know than guess. If you answer yes to any, we may ask for medical clearance from your GP before starting training.

1. Has your doctor ever said that you have a heart condition OR high blood pressure?

No

Yes

Please describe

2. Do you feel pain in your chest at rest, during daily activities, OR when you do physical activity?

No

Yes

Please describe

3. Do you lose balance because of dizziness OR have you lost consciousness in the last 12 months? (Answer NO if dizziness was associated with over-breathing during vigorous exercise.)

No

Yes

Please describe

4. Have you ever been diagnosed with another chronic medical condition (other than heart disease or high blood pressure)?

No

Yes

List condition(s)

5. Are you currently taking prescribed medications for a chronic medical condition?

No

Yes

List condition(s) and medication(s)

6. Do you currently have (or have had in the past 12 months) a bone, joint, or soft tissue problem that could be made worse by becoming more physically active? (Answer NO if a past problem doesn't limit your current activity.)

No

Yes

List condition(s) and any current treatment / physio

7. Has your doctor ever said you should only do medically supervised physical activity?

No

Yes

Please describe

Anything else we should know (recent illness, surgery, pregnancy, current physio, mental-health considerations, ADHD/neurodivergence-relevant detail, allergies)

03 Inherent risks of training

What I understand & accept.

Triathlon training, strength & conditioning, breathwork and the wider Coaching Programme involve physical exertion that carries inherent risks. Please tick to confirm each statement.

Inherent risks. I understand that physical exertion carries inherent risks of injury including (but not limited to) muscle soreness, strains, sprains, ligament or tendon damage, joint injury, falls, cardiovascular events, heat exhaustion, dehydration, and aggravation of pre-existing conditions. I voluntarily accept these inherent risks as part of training. Honest disclosure. The information I have given on this form is true, accurate and complete to the best of my knowledge. I will tell my coach as soon as practical if any of it changes — new injury, new diagnosis, new medication, pregnancy, or anything else relevant to my safety while training. Not medical advice. I understand that Unbroken Protocol provides performance coaching, not medical advice or treatment. If I have any condition that makes exercise potentially unsafe, I will obtain clearance from my GP before starting or continuing training. I will not rely on my coach for medical decisions. I will stop if something is wrong. If I experience pain, dizziness, chest tightness, shortness of breath beyond normal exertion, or any other warning sign during training, I will stop immediately and tell my coach. I will not push through serious warning signs. Coach's judgement on progression. I understand that my coach may refuse, modify or end any session, exercise or programme element where they reasonably judge it unsafe for me to continue. I will not pressure my coach to override their professional judgement.

04 What Unbroken Protocol commits to

Our duty to you.

This isn't a one-sided waiver. We owe you a real duty of care; this records both sides of it.

Unbroken Protocol commits to:

1. Deliver coaching with reasonable care and skill, in line with the Consumer Rights Act 2015 (s.49).
2. Programme training appropriate to your screened health profile, fitness level and stated goals.
3. Maintain a safe training environment at the Club, including equipment that is fit for purpose.
4. Hold appropriate Public Liability and Professional Indemnity insurance in respect of our coaching services.
5. Keep your health and personal information confidential, in line with the UK GDPR and our Privacy Policy.
6. Refer you back to a qualified medical professional any time a question is outside the scope of performance coaching.

05 Declaration & signature

Signing this off.

By signing below I confirm I have read, understood and agree to the statements in this form. I understand that this signature is electronic and has the same legal effect as a handwritten signature under the Electronic Communications Act 2000.

I confirm the above and I am at least 18 years old. I confirm I have read and agree to the Terms of Service and the Privacy Policy. I understand that nothing in this form removes my statutory rights as a consumer, and nothing in this form excludes Unbroken Protocol's liability for death or personal injury caused by their negligence (Consumer Rights Act 2015, s.65).

Type your full name as your signature

This is your binding signature. It will be timestamped, stored against your account, and a copy will be emailed to you.

Full legal name *

Date signed

A signed copy will be emailed to you for your records.

Health screening
& waiver.

The basics.

The seven health questions.

What I understand & accept.

Our duty to you.

Signing this off.

Type your full name as your signature

Cleared. See you Saturday.

Health screening& waiver.

The basics.

The seven health questions.

What I understand & accept.

Our duty to you.

Signing this off.

Type your full name as your signature

Cleared. See you Saturday.

Health screening
& waiver.