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Balance Fitness & Health Intake Form

Your Goals

Medical/ Orthopedic Conerns

Fitness Evaluation

Nutrition Evaluation

Sleep Evaluation

HOLD HARMLESS AGREEMENT

I hereby affirm that I am entering the course of instruction in physical fitness and performance training. By enrolling in this course, I certify that I am cognizant of all inherent dangers of physical fitness. I understand and am aware that resistance, flexibility, and aerobic exercise, including the use of equipment, is potentially hazardous activity. In consideration of enrolling in personal training activity, I hereby assume all risks connected with such activity including possible injury or death.Conscious of all risks including death I am participating in these activities voluntarily and assume all responsibility by my involvement.

I hereby waive, release, and discharge the instructor, program and agents from any and all claims or liabilities for injuries or damages to my persons due to my participation. I also hereby indemnify and hold harmless all the above release from any and all liabilities incident to my involvement in these programs,even if arising from their negligence.

I have read this release of liability and assumption of risk agreement, fully understand its terms, understand that I have given up substantial rights by signing it, and sign it freely and voluntariy without inducement.

Commitment/ Cancellation Agreement

If you must cancel your session, please cancel no less than -hours of your scheduled time.

Cancelled sessions less than 12-hours will be charged.

I, agree to participate in trainingX per week for the next weeks. In the event I am unable to make my scheduled time(s) I am required to schedule a make-up session for that week or the following. Failing to reschedule will forfeit the session resulting in a charge.

Your scheduled session is time you have committed to yourself and Balanace Fitness & Health. Let's work together to reinforce your goal and Healthy Lifestyle. Your continued Commitment will give you the consistency needed to reach your goals.


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