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Informed Consent -
I, , acknowledge that I have voluntarily chosen to participate in a program of progressive physical exercise. I understand such a program can enhance the musculoskeletal and cardiorespiratory systems. I also understand there are inherent risks in participating in a program of strenuous exercise. I have been informed of the possible strenuous nature of a personal training program and the potential for unusual, but possible, physiological results including, but not limited to, abnormal blood pressure, muscle soreness, fainting, heart attack or death.
I have read and understand this term: (initial)
I understand that I am not obligated to perform nor participate in any activity that I do not wish to do, and that it is my right to refuse such participation at any time during my training sessions. I understand that should I feel lightheaded, faint, dizzy, nauseated, or experience pain or discomfort, I am to stop the activity and inform my Personal Trainer. I give Lex Richards and the staff of the facilities I train in permission to seek emergency medical services for me should I become injured or ill with the understanding that I am responsible for any expenses incurred.
I have read and understand this term: (initial)
I understand that Lex and other trainers operate on a scheduled appointment basis for all training sessions and thus, require that I provide 24 hours notice when canceling an appointment. Otherwise session will still be charged.
I have read and understand this term: (initial)
All pre-purchased sessions are valid for one year. All pre-purchased sessions are non-refundable. All pre-purchased sessions are not nullified due to scheduling difficulties.
I have read and understand this term: (initial)
Because physical exercise can be strenuous and subject to risk of serious injury, we urge you to obtain a physical examination from a doctor before using any exercise equipment or participating in any exercise activity. You agree that by participating in physical exercise or training activities, you do so entirely at your own risk. Any recommendation for changes in diet including the use of food supplements, weight reduction and/or body building enhancement products are entirely your responsibility and you should consult a physician prior to undergoing any dietary or food supplement changes. You agree that you are voluntarily participating in these activities and use of these facilities and premises and assume all risks of injury, illness, or death. We are also not responsible for any loss of your personal property.
You acknowledge that you have carefully read this “waiver and release” and fully understand that it is a release of liability. You expressly agree to release and discharge the trainer or instructor from any and all claims or causes of action and you agree to voluntarily give up or waive any right that you may otherwise have to bring a legal action against the trainer or instructor for personal injury or property damage.
To the extent that statute or case law does not prohibit releases for negligence, this release is also for negligence.
If any portion of this release from liability shall be deemed by a Court of competent jurisdiction to be invalid, then the remainder of this release from liability shall remain in full force and effect and the offending provision or provisions severed here from.
By signing this release, I acknowledge that I understand its content and that this release cannot be modified orally.
Signed: __________________________________
Printed Name: _____________________________
Dated: ___/___/___
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