Fill and Sign the Agreement Personal Form

Agreement Between Personal Trainer and Client Agreement made this       day of       , 20       , by and between       of       , (Name of Personal Trainer) (Street Address, City, County, State, Zip Code) referred to herein as Trainer, and       of (Name of Client)       , referred to herein as Client. (Street Address, City, County, State, Zip Code) In consideration of my being able to participate in the a personal training program, Client understands and agrees that he must purchase a single or package of training session(s) and must read, agree to and sign this Agreement whereby he assumes the risks for participation, waives liability, and agrees to the Personal Training Policies and Procedure . Client further understands and agrees to the following: 1. The program is voluntary and Trainer will develop and guide Client through the exercise program. 2. Client will be required to undergo a graduated exercise test (fitness evaluation) to assess his present level of fitness. 3. Client represents that he will complete the Lifestyle Questionnaire and any other health history accurately and completely including disclosure of any prescribed medications Client is taking and any exercise or diet limitations Client is aware of or has been informed of by Client’s doctor. 4. During the program, if Client’s medications, condition, or medical limitations should change, Client will notify the Trainer. 5. Client understands that it is recommended that he have a yearly physical or more frequent physical examinations and consultations with his physician as to physical activity and diet which are appropriate for Client. Client acknowledges that he either has had a physical exam and or been given his physician’s permission to participate or that he has decided to participate without approval of his physician. 6. Client understands that a Trainer will review his Lifestyle Questionnaire and any other health history form but agrees that Trainer is not a physician and cannot replace the advice and expertise of a physician. 7. Client understands that he has the complete right to stop or decrease exercise at any time during a session and that it is his obligation to inform the Trainer of any symptoms such as fatigue, shortness of breath or chest discomfort. Agreement Between Personal Trainer and Client Page 1 of 3 8. Client realizes that participation in the program will include, but not be limited to, exercising, use of exercise equipment and strenuous exertion (strength training) all of which increase heart rate and body temperature. 9. Client understands that exercise involves certain risks, including but not limited to, serious neck and spinal injuries resulting in complete or partial paralysis, heart attack, stroke or even death; and that injuries could occur to bones, joints or muscles. Client understands that slips, falls, and unintended loss of balance could result in muscular, neurological, orthopedic or other bodily injury. Client further understands that part of the risk involved in undertaking any activity or program is relative to his own state of fitness or health (physical, mental, or emotional) and to the awareness, care and skill which he conducts himself in that activity or program. 10. Knowing the material risks, and reasonably anticipating that other injuries are a possibility, Client hereby expressly assumes all of the delineated risks of injury, all other possible risk of injury, and even risk of possible death, which could occur by reason of Client’s participation. 11. Client does hereby waive, release and forever discharges the Trainer and the       from any and all responsibilities or liability for any present (e.g., Name of Gym) and future injuries or damages resulting or arising from Client’s participation in any activities including but not limited to exercise, personal training or use of equipment including any injuries and damages caused by the negligent act or omission of any of those persons or entities mentioned above. Client declares that he understands and agrees to the contents of this Agreement in its entirety, including the Training Policies and Procedure set below . WITNESS our signatures as of the day and date first above stated. By: By: (Signature of Client) (Signature of Trainer)             (Printed Name of Client) (Printed Name of Trainer) Personal Training Policies and Procedure:  Package sessions are non-refundable.  Package sessions must be paid in full and are scheduled at the time of sign-up.  Package sessions must be used within six months of the purchase date.  Client must give 24 hours advanced notice, less than 24 hours or a no-show will result in a charge to the package session.  Lifestyle Questionnaire, Physician Approval (if applicable), and Personal Training Agreement must be completed, signed, and on file prior to the beginning of the first session. Agreement Between Personal Trainer and Client Page 2 of 3  Training sessions will begin promptly at the time specified by the client and trainer and end one hour from that specified time.  Personal training sessions that are not rescheduled or canceled 24 hours in advance will result in forfeiture of the session and a loss of the financial investment at the rate of one session.  Clients who arrive late will receive the remaining scheduled session time, unless other arrangements have been previously made with the trainer.  All personal training sessions within 120 days from the date of the Agreement. Personal training session obligations are void after this time period.  No personal training refunds will be issued for any reason, including but not limited to relocation, illness, and unused sessions.  Description of program: Training Sessions  Per Session – Single person = $45.00  Per Session – Two people = $75.00  Per Session – Three people = $90.00  Pre schedule – Pre Pay  5 Sessions = $       (Savings of $       per session)  10 Sessions = $       (Savings of $       per session) Total Amount to be Paid: $       Method of payment:       (Signature of Client)       (Printed Name of Client) Agreement Between Personal Trainer and Client Page 3 of 3