Sports Performance New Athlete Registration - Architech Sports and Physical Therapy

SPORTS PERFORMANCE
NEW ATHLETE REGISTRATION FORM

To get started, please follow these simple steps:

Complete the New Athlete Health Questionnaire: This helps us understand your current fitness level, any past injuries, and your training goals.
Sign the Release Form: This is a standard waiver acknowledging the inherent risks associated with physical activity and training.
Create your MindBody Account: MindBody is the platform we use for scheduling and managing training sessions. You’ll use this account to sign up for upcoming training sessions and manage your schedule.

Once you’ve completed these steps, you’ll be ready to start your journey to peak performance with Architech Sports Performance!

Need Help?
If you have any questions or need assistance with any of these steps, please don’t hesitate to contact the Luke Williams, the Director of Sports Performance at luke@architechsports.com.

Step 1 of 2 - Health History Questionnaire

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This field is for validation purposes and should be left unchanged.

Athlete Name(Required)

First Last

Age(Required)

Birthdate(Required)

MM slash DD slash YYYY

Parent or Guardian(Required)

if under the age of 18.

First Last

Email(Required)

Enter Email Confirm Email

Phone(Required)

Address(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code

Please select your desired training location from the list below.(Required)

Comments(Required)

Please let us know what's on your mind. Have a question for us? Ask away.

Have you seen a doctor in the past year for any medical problems?(Required)

Yes

In the past year, have you required any taping, wrapping, or bracing for participation in athletics?(Required)

Yes

Have you ever experienced chest pain, "racing heart", irregular heartbeat, difficulties breathing or catching your breath while exercising or playing a sport?(Required)

Yes

Have you ever experienced nausea, dizziness, severe cramping or fainting from heat which forced you to stop the activity?(Required)

Yes

Have you ever passed out during a sport activity/exercise or lost consciousness due to a head injury?(Required)

Yes

Have you ever had sports induced asthma?(Required)

Yes

Do you need to have an inhaler?

Yes

Do you have diabetes?(Required)

Yes

Have you ever had shin splints?(Required)

Yes

Has anyone in your family had a history of heart disease or stroke before the age of 50?(Required)

Yes

Have you pulled or strained a muscle within the past year?(Required)

Yes

Are you currently taking any medication?(Required)

Yes

If yes, list all medications.

Is there any condition that might limit your participation in this program?(Required)

Yes

If yes, please explain.

In the past 3 years, have you had any injuries, surgeries or problems with the following areas?(Required)

Lower Back

Neck

Ankle

Knee

Shoulder

None of the above

Are you currently involved in a strength program?(Required)

Yes

If yes, what kind?

Have you had a physical in the past year?(Required)

Yes

Are you a current member of the YMCA? (Not required to participate in Architech Sports Programs)(Required)

Yes

Consent(Required)

I certify that the above information is accurate to the best of my knowledge.

Electronic Signature(Required)

I the undersigned patron of ARCHITECH SPORTS AND PHYSICAL THERAPY, INC. (ARCHITECH SPORTS) hereby state and represent as follows:(Required)

1. I have no known medical problems that would preclude me from participation in any of ARCHITECH SPORTS’ programs, and the information I have provided to ARCHITECH SPORTS regarding my medical condition and physical condition is true and correct to the best of my knowledge.

2. My participation in any of ARCHITECH SPORTS’ programs is voluntary, and I have the right to withdraw from any of the programs at any time.If I withdraw from the programs, however, I am still responsible for any monetary obligations that I may have incurred in the course of my participation.

3. Neither ARCHITECH SPORTS, nor any of it agents or representatives, has guaranteed me success in any of the programs.

4. I hereby agree to forever waive any and all claims that I have against ARCHITECH SPORTS or its agents or employeesas a result of my participation in any of ARCHITECH SPORTS’ programs. This release shall be binding on my heirs, legal representatives and assigns.

5. I hereby consent to and permit ARCHITECH SPORTS to use the data obtained as a result of my participation in ARCHITECH SPORTS’ programs in reports or publications, but my identity will not be revealed in any such reports unless I have given my specific consent to do so.

6. I am aware of ARCHITECH SPORTS’ late/no show policy, which states that if I do not show up for my appointment within 15 minutes of the session time, ARCHITECH SPORTS has the option of counting that session as if it were used.

7. I am aware that any sessions remaining in my program will be forfeited if not used within six months, unless alternate arrangements have been with ARCHITECH SPORTS in advance.

8. In the event of physical injury resulting from my participation in any of ARCHITECH SPORTS’ programs, no medical or monetary compensation will be provided to me by ARCHITECH SPORTS. I will assume and pay, either personally or through my own medical insurance coverage, for all medical bills or expenses incurred as a result of my participation in ARCHITECH SPORTS’programs.

9. Risk and discomforts: When participating in athletic development programs, as with any sport/athletic activity, thereexists the possibility of straining muscles and spraining ligaments. ARCHITECH SPORTS will try to minimize these risks. It is not uncommon to experience some delayed onset muscle soreness when starting a conditioning program.

10. At ARCHITECH SPORTS, we believe in celebrating the achievements of our patients and athletes. We strive to showcase their dedication, hard work, and resilience throughout their journey with us, whether it's recovering from an injury or completing one of our programs. To share their inspiring stories, we may capture photos and videos to post on our social media platforms.

I have read this release and the information provided to me by ARCHITECH SPORTS, and I understand that I am signing a complete release from any claim resulting from my participation in any of ARCHITECH SPORTS’ programs.

Athlete's Electronic Signature(Required)

Parent or Guardian's Signature (if under the age of 18)

The above-named client is under the age of 18 years. I have reviewed the information provided and certify it to be true and correct. I represent that the client is currently covered under my medical insurance, and I consent to the athlete named above participating in ARCHITECHSPORTS’ PROGRAMS.

SPORTS PERFORMANCENEW ATHLETE REGISTRATION FORM

SPORTS PERFORMANCE
NEW ATHLETE REGISTRATION FORM