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CLIENT INTAKE FORM
Odin's Iron Temple
Complete all required fields marked with *. Your information is private and used exclusively for your coaching program.
Contact & Basics Section 1 of 5
Contact & Basics
Your personal information — kept private, never shared.
Q1
Q2
Q3
Q4
Q5
Health & Safety Screening
Required for your safety. All answers are confidential.
ᚨ This section follows PAR-Q+ safety guidelines. Answer honestly — your responses directly shape how your program is built and what exercises are selected.
Q6
Yes
No
Q7
Yes
No
Q8
Yes
No
Q9
Yes
No
Q10
Yes
No
Q11
Yes
No
Q12
Yes
No
Include prescriptions, over-the-counter medications, and supplements. This is used to flag potential food-drug interactions in your nutrition plan.
Q13
Yes
No
Goals & Logistics
What you're working toward and what you're working with.
Q14
🔥 Lose Body Fat
💪 Build Muscle
⚖ Body Recomposition
🏋 Strength
⚡ Athletic Performance
🏆 Competition Prep
🩺 Rehabilitation
❤ General Health
Q15
Q16
Q17
Strength Training
Bodybuilding
Powerlifting
Olympic Lifting
HIIT
CrossFit / Functional
Cardio / Endurance
Mobility / Yoga
Group-Style
General / Not Sure
Q17b
🏋 Commercial Gym
Full equipment
🏠 Home Gym
Barbell + rack + DBs
🪙 Dumbbells Only
DBs, bands, bodyweight
🧘 No Equipment
Bodyweight only
Q17c
🌱 Less than 1 year
Beginner
⚡ 1–3 years
Intermediate
🔱 4+ years
Advanced
🔄 Returning after break
Had a gap
Q17d
Q18
Yes
No
Q18b
Q18c
Coaching Plan
Choose your tier — all plans are month-to-month, no contracts.
Q19
ᚠ IRON — Training Only $149/mo
Training program · Workout logging · Weekly check-ins · Supplement guidance · 48hr messaging
ᚱ FORGE — Training + Nutrition $249/mo
Everything in Iron · Nutrition coaching · Body measurements · Progress photos · Weight trend · 24hr messaging
★ MOST POPULAR
ᛟ VALHALLA — Full Service $399/mo
Everything in Forge · Video calls · 12-week periodized programming · Same-day messaging · Custom printed booklet mailed to you ($70 value)
Not Sure Yet — Let's discuss on the consultation call
Liability Waiver & Consent
Read carefully before signing.
Q20

LIABILITY WAIVER AND RELEASE OF RESPONSIBILITY

I, the undersigned, acknowledge that I am voluntarily participating in a fitness and nutrition coaching program provided by Odin's Iron Temple, owned and operated by Jonathon Irvine.

Assumption of Risk: I understand that participation in physical exercise and dietary changes involves inherent risks, including but not limited to muscle soreness, injury, or aggravation of pre-existing conditions. I voluntarily assume all risks associated with participation in this program.

Medical Clearance: I confirm that I have answered all health screening questions truthfully and completely. I understand that it is my responsibility to obtain medical clearance from a licensed physician before beginning any exercise program, particularly if I answered "Yes" to any health screening question above.

Nutritional Advice: I understand that nutritional guidance provided by Odin's Iron Temple is not a substitute for advice from a licensed medical professional or registered dietitian. I assume full responsibility for any dietary changes I make.

Release of Liability: In consideration of being allowed to participate in this program, I hereby release, waive, discharge, and covenant not to sue Odin's Iron Temple, Jonathon Irvine, or any affiliated parties from any and all liability, claims, demands, actions, or rights of action, which are related to, arise out of, or are in any way connected with my participation in this coaching program.

Photo/Data Consent: I consent to the use of my progress data (measurements, weight, check-in responses) for the purpose of building and adjusting my coaching program. Progress photos, if submitted, will remain private and will not be shared without my explicit written consent.

Cancellation Policy: All plans are month-to-month. I may cancel at any time with notice before my next billing cycle. No refunds are issued for the current billing period.

By signing below, I confirm that I have read, understood, and agree to all terms of this waiver.

Typing your name above constitutes your electronic signature and is legally binding.
Your information is encrypted and kept strictly confidential.

Intake Submitted

Your intake has been received and your warrior profile has been created. One last step — complete your first month's payment to lock in your spot.

YOUR PLAN
▶ PAY WITH SQUARE
Secure payment via Square. Month-to-month — cancel anytime. After payment, Coach Jonathon will reach out within 24 hours to schedule your kickoff call.

Already paid or prefer another method? Email coach@odinsirontemple.net

WELCOME TO ODIN'S IRON TEMPLE.