Fill and Sign the Personal Training Form

Personal Training Program Registration Form and Waiver Please Print or Type Name: ________________________________________ Phone: ___________ Mailing Address: _______________________________________________ _______________________________________________ Email Address: __________________________ Date of Birth: ___________________ Age: ______________ Gender: ______________ Name of Emergency Contact: ________________________________________ Phone Number of Emergency Contact: ________________________________ Personal Training Program Policies:  Each participant must sign a waiver and complete a health history questionnaire to be kept on file and will be confidential between the personal trainer and the client.  Participants must make appointments with at least _____ hours in advance or by ___________ (time) for _______________ (day of week) sessions.  ____________________ (Name of Trainer) must be notified _______ hours in advance for cancellations; if notification is not at least _______hours in advance or the session is missed the participant will be charged for the session.  Participants ____ minutes late or more to a session will be charged for the session and lose the training for the entire session.  Clients are to meet the personal trainer at the agreed upon training venue at the scheduled appointment time, unless an alternate meeting place as been agreed upon between client and the personal trainer. For and in consideration of being allowed to receive personal fitness training from _________________ (Name of Trainer) , and the mutual covenants contained in this Agreement, and other good and valuable consideration, the receipt and sufficiency of which is hereby acknowledged, the undersigned ___________________ (Name of Participant) agrees to the above Personal Training Program Policies and does hereby further agree to the following: 1. It is hereby agreed that I, _____________________ (Name of Participant) , do fully comprehend and assume all risks involved in participating in this Personal Training Program. I have been advised by ________________ (Name of Trainer) to consult my physician prior to my participation in said Program to insure that I am physically able to engage in strenuous physical activity. 2. Being fully cognizant, and assuming all risks involved in the Personal Training Program offered by ________________ (Name of Trainer) , I do hereby remise, release, quitclaim, and forever discharge _________________ (Name of Trainer) , his employees or agents, administrators, successors and assigns, of and from any and all manner of actions, suits, debts, accounts, damages, judgments, executions, claims, or demands whatsoever in law or equity, or otherwise, against ___________________ (Name of Trainer) , his employees or agents, administrators, successors and assigns, which I, my heirs, executors, or administrators hereafter can, shall or may have, for, upon or by reason of any injury that I may sustain or incur while participating in the Personal Training Program of ________________ (Name of Trainer) , or while engaging in physical conditioning exercises. 3. In consideration of being allowed to participate in said Personal Training Program , I do hereby assume all risks of my involvement and do covenant and agree not to bring legal action for damages should I sustain any injury, and do further release _________________ (Name of Trainer) , his employees or agents, administrators, successors and assigns from all acts of active or passive negligence on the part of ________________ (Name of Trainer) , his employees or agents, administrators, successors and assigns. 4. I also agree to INDEMNIFY AND HOLD release _____________________ (Name of Trainer) , his employees or agents, administrators, successors and assigns harmless from any and all claims, actions, suits, procedures, costs, expenses, damages, and liabilities, including attorney’s fess brought as a result of my involvement in said Personal Training Program and to reimburse them for any such expenses incurred. 5. I do hereby certify and covenant that I am above the age of 18. Witness my signature this _________________ (date) . ____________________________ (Printed Name of Participant) ____________________________ (Signature of Participant) ____________________________ (Printed Name of Witness) ____________________________ (Signature of Witness)