(425) 778-3546
160 West Dayton, Edmonds, WA 98020
Club Hours
Mon – Fri:
5a – 9p
Sat-Sun:
7a – 8p
Schedules & Reservations
Group Fitness Schedule
Pickle Ball Schedule
Manage My HSAC Account
MÜV Training Client Scheduler
Reserve A Tennis Court
Tennis Group Class Schedule
COVID UPDATES
About Us
Our Facilities
Vendors & Partners
Reciprocal Location
Donation Requests
Contact Us
NOW HIRING
Membership
Membership Options
Manage My Account
Programs & Services
Personal & Group Training
MÜV Group Training
Health Coaching
Personal Training
Our Trainers
Pilates
Ski Strong
Tai Chi
Booty by Tina
Our Programs
Basketball
Smoothie Bar & Eats
Kids & Families
KidZone
Aquatic Programs
Junior Tennis Lessons
Massage
Pro Shop
Racquet Sports
Specialty Programs
Enneagram Workshop
Injury Screening
THRIVE™ Mindfulness Class
Group Fitness Classes
Group Aquatics
Group Fitness Classes
Group Fitness Schedule
Conditioning
Pilates (mat driven)
Studio Cycling
Yoga
Zumba
Tennis
About Tennis Lessons
FREE Beginner Tennis Lesson
Tennis Group Class Schedule
Book A Court
Competitive Lessons
Social Programs
Junior Tennis Lessons
Pickleball
Blog
COVID UPDATES
About Us
Our Facilities
Vendors & Partners
Reciprocal Location
Donation Requests
Contact Us
NOW HIRING
Membership
Membership Options
Manage My Account
Programs & Services
Personal & Group Training
MÜV Group Training
Health Coaching
Personal Training
Our Trainers
Pilates
Ski Strong
Tai Chi
Booty by Tina
Our Programs
Basketball
Smoothie Bar & Eats
Kids & Families
KidZone
Aquatic Programs
Junior Tennis Lessons
Massage
Pro Shop
Racquet Sports
Specialty Programs
Enneagram Workshop
Injury Screening
THRIVE™ Mindfulness Class
Group Fitness Classes
Group Aquatics
Group Fitness Classes
Group Fitness Schedule
Conditioning
Pilates (mat driven)
Studio Cycling
Yoga
Zumba
Tennis
About Tennis Lessons
FREE Beginner Tennis Lesson
Tennis Group Class Schedule
Book A Court
Competitive Lessons
Social Programs
Junior Tennis Lessons
Pickleball
Blog
Challenge intake form.
Help us. Help you.
Complete the form below.
Participant Info and Consent.
First Name
*
Last Name
*
Street Address
City
Email
*
Entering your email is for us to notify you of challenge news, tips, events, and other important info that pertains to the challenge. We will NOT spam you or share your email with anyone.
Phone
How did you hear about the HSAC 60-Day Challenge?
*
Facebook
Instagram
Email
myEdmondsNews
Current Member
In Club Marketing (newsletter/poster)
What size shirt do you wear?
*
S - Small
M- Medium
L -Large
XL - Extra Large
XXL - Extra Extra Large
The shirt will be an Anvil - Unisex Cotton Blend Shirt
Date of Birth
*
Date Format: MM slash DD slash YYYY
Challenge terms and consent
By typing your name below, you are agreeing to the stipulations and requirements of Harbor Square Athletic Club and the HSAC 60-Day Challenge. Please read the information carefully, type your name in the blank provided above to indicate you accept the challenge and its terms.
Typing my name above signifies I understand that the HSAC 60-Day Challenge is not a medically supervised system and was developed for healthy people with no medical conditions or risks (physical or psychological) If I have an existing medical condition, before I can begin, I will present my assigned Team Captain with a Physician’s Release Form, signed and date by my personal physician.
I will not hold Harbor Square Athletic Club or any related persons or parties personally liable for any problems, illnesses, or injuries that might occur due to a sudden change in my eating habits.
This weight management program does not replace the expert advice or medical treatment of my own private doctor. I have given my Team Captain, Assistant Captain, Training Staff, all the necessary information about myself to prevent any complications.
All photos and videos taken of my likeness by Harbor Square Athletic Club can be used in conjunction with the HSAC 60-Day Challenge program and other promotion of their weight loss and training programs. I release all claims for any compensation from the use of these photos and understand they will be the property of Harbor Square Athletic Club to be used at their discretion for promotion and marketing campaigns.
Type your name to accept challenge:
*
Physical Activity Readiness Questionnaire
Please read each question carefully and answer either “yes” or “no”.
1. Have you been diagnosed with a heart condition?
*
Choose
Yes
No
2. Do you have chest pain brought on by physical activity?
*
Choose
Yes
No
3. Do you tend to lose consciousness or fall over as a result of dizziness?
*
Choose
Yes
No
4. Are you taking medication for your blood pressure or a heart condition?
*
Choose
Yes
No
5. Do you have a bone or joint problem that could be aggravated by the proposed physical activity?
*
Choose
Yes
No
If "yes" to #5 - Please explain.
6. Are there other physical ailments we should be aware of and monitor as you engage in this activity?
*
Choose
Yes
No
If "yes" to #6 - Please explain.
7. Have you undergone any surgery in the past two years (major or minor)?
*
Choose
Yes
No
If "yes" to #7 - Please explain.
8. Are you over the age of 65 and not accustomed to vigorous exercise?
*
Choose
Yes
No
9. Is there anything, not mentioned above, that we should be aware of in order to design a safe and effective workout program for you?
*
Choose
Yes
No
If "yes" to #9 - please describe in detail.
Health History
Please check all that apply.
Heart Disease or Stroke
Lung/Pulmonary Disease
Gastrointestinal Disease
Diabetes
Metabolic Disease
Pregnancy/Trying to Conceive
Anemia
High Blood Pressure
Kidney/Liver Disease
Chronic Diarrhea
Food Allergies
Immune System Disease
Breastfeeding
Hypertension
Cancer
Ulcer
Depression
Neuromuscular Disease
Diagnosed Eating Disorder
Pancreatitis
Hypoglycemia
Health Habits
Please answer the following questions.
Do you smoke?
Choose
Yes
No
If "yes" to smoking, how much?
Rarely/Social Settings
Less than one pack per day
More than one pack per day
Do you drink alcohol?
Choose
Yes
No
If "yes" to drinking alcohol, how much?
Rarely/Social Settings
One to two beverages per week.
Three to four beverages per week.
Five or more beverages per week.
How much do you sit per day?
Choose
Less than 4 hours/day
4 - 7 hours/day
7+ hours/day
Please consider commuting, leisure, and work.
Does your work require travel?
Choose
Yes
No
Can you share what type of work you do (optional)?
This question is asked to help determine repetitive movement patterns (sitting, lifting, rotating, etc.) that we can keep in consideration for your fitness plan. Also it helps us work with your schedule in creating a program.
How much sleep do you get per night?
Less than 4 hours of sleep
4 - 6 hours of sleep
6 - 8 hours of sleep
8+ hours of sleep
Do you feel rested and rejuvenated when you wake?
Choose
Well rested and energized!
Somewhat rested. Ok energy.
Not rested. Give me coffee.
Still fatigued. Need more sleep but have to get going.
Select what best describes you.
How often do you cook your own meals?
Choose
I cook/prepare every meal
I cook/prepare most meals
I grab pre-made meals and cook some meals
I'm on the go - mostly pre-made meals, rarely do I cook.
I don't cook or prepare any meals
What best describes your meals overall?
Choose
Meat & potatoes
Lots of veggies with some meats
Vegetarian
Vegan
Equal parts veggies, meats, and starches
Primarily seafood
Paleo
Fast Food
What supplements, if any, are you taking?
Daily Multi-Vitamin
Calcium
Antioxidant
Probiotics
Protein Powder (Meal Replacement)
Protein Bar
Amino Acids
Omega-3
Creatine
Energy Booster
Vitamin C
Joint Support
Vitamin D
Weight Loss
CoQ10
Spirulina
Blue/Green Algae
Magnesium
Potassium
Which supplements would you like more info on?
General health supplements (multi, omega-3, calcium, etc.)
Weight Loss (lean protein powder, fat burner, carb blocker, etc)
Lean Muscle Gain (Protein, Amino Acid, Pre-workout)
Athletic Performance (Creatine, Protein Powder/Bars)
General Info to learn more how supplements can help me overall.
HSAC 60-Day Challenge Goals
Share with us your goals and how we can support you during this challenge.
Which category will you be entering?
*
Choose
Weight Loss
Lean Muscle Gain
What is you goal weight loss in pounds (lbs)?
*
Choose
5 to 10lbs
10 to 20lbs
20lbs and more.
Please keep in mind that 'healthy' weight loss is at a rate of 1 - 3lbs per week. However each person is different and results will vary.
What is your goal in lean muscle gain?
*
Choose
3 to 5lbs
5 to 8lbs
8 to 10lbs or more
What motivated you to join the challenge?
Lifestyle change
The need to lose weight
The desire to increase lean muscle
The desire to improve strength
I need to be held accountable
I have an upcoming event
I need more nutrition help
I want some personalized programming help
The chance to win some cash and prizes
To push for a goal with other 60-Day Challenge members
To prove to myself I can finish the challenge
To support another participant and get fit
Check all that apply.
Please let us know how we can best support you during this challenge, or list any questions that you may have.