Home
About
About FBD
Rob & Lisa
Our Team
Online Options
Fitness
Personal Training
Small Group
Yoga Classes
Forms
Members
Client Care #COVID
Blog
Contact Us
Home
About
About FBD
Rob & Lisa
Our Team
Online Options
Fitness
Personal Training
Small Group
Yoga Classes
Forms
Members
Client Care #COVID
Blog
Contact Us
Name
*
First Name
Last Name
Email Address
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1. I acknowledge and agree that certain risk on injury exists when participating in a body fitness training program utilizing weight training, weight lifting, functional training, and other exercise modalities. It is expressly agreed that all exercises and modalities SHALL BE UNDERTAKEN BY ME AT MY SOLE RISK, and Fitness by Design shall not be liable to me for any claims, demands injuries, damages, actions or causes of action whatsoever to my person or property arising out of or connected with the use by me of the services and facilities of Fitness by Design and its agents, employees, and servants, whether said services are provided on or off the business premises. I further hereby expressly forever waive, release and discharge Fitness by Design from any and all claims, demands, injuries, damages, actions or causes of action and from all acts of active or passive negligence on the part of said corporation, its agents, employees, and servants.
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Yes
No
2. I certify that the answers to the questions outlined on the PAR-Q form are true and complete to the best of my knowledge. I acknowledge that medical clearance is required if I have answered YES to any of the questions on the PAR-Q form. I understand and agree that it is my responsibility to inform my Personal Trainer of any conditions or changes in my health, now and on going, which might affect my ability to exercise safely and with minimal risk of injury.
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Yes
No
3. 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.
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Yes
No
4. I understand the results of any fitness program cannot be guaranteed and my progress depends on my effort and cooperation in and outside of the sessions.
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Yes
No
5.
PAYMENT:
I understand that Fitness by Design bills its Personal Training Clients on a pre-pay basis. Once my trainer and I have decided upon the type of training package and payment plan I will purchase, payment must be made before the sessions are conducted. Credit cards, cash and checks made payable to Fitness by Design are all accepted.
I understand that all Personal Training sessions are non-refundable, however they are transferable to family or friends. An EFT agreement must be signed if you wish to keep your payment method saved in our POS system. Your account will be charged for the following events:
o Completion of a scheduled session
o Failure to show for a scheduled session
o Late cancellation of a scheduled session (less than 12 hours)
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Yes
No
6.
CANCELLATION:
I understand that Fitness by Design operates on a scheduled appointment basis for all Private Training sessions and thus, requires that I provide 12 hours notice when canceling an appointment. No charge will be levied should I cancel with more than 12 hours notice given. Should I cancel a session without 12 hours prior notice, I will be charged in full for that session. I understand that Fitness by Design recommends that all Personal Training cancelled sessions be rescheduled to ensure consistency and fitness progress.
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Yes
No
7. Assignment of Personal Trainers: Fitness by Design is a team of trainers. In general you will work with one employee of Fitness by Design, but in some circumstances you may workout with a different employee (trainer) based on your scheduling, trainer vacation, illness, etc… You are encouraged to work with the trainer assigned to you during their absence. Rob and Lisa are responsible for trainer assignments and want to keep you as a satisfied customer. Your requests will be honored when possible, and your satisfaction is guaranteed or you will not be charged for the appointment.
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I understand
8. All children are strictly prohibited from the exercise floor unless working out with a personal trainer and a signed waiver form is on file. Children under the age of 8 are required to be supervised.
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I understand
9. I understand that the usage of any nutritional supplements is done under my own will and has not been prescribed by my Personal Trainer.
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Yes
No
10. I understand that Fitness by Design photographs many of their client event/sessions and I provide written approval for them to use these pictures for promotional purposes.
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Yes
No
11. Valuables: Please do not leave purses/bags under the reception area desk. We are not responsible for them. Lockers are available in the locker rooms. We recommend that you do not leave valuables visible in your car. We have locks for you use if you want one. Lockers may be rented for $5 per month ($60/year).
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Yes
No
12. Our Promise: If your trainer misses a scheduled workout he/she will make up that workout and credit you one additional session.
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I understand
ADDITIONAL WAIVER REQUIRED BEFORE EXERCISING OR STAYING ON PREMISES:
By entering Fitness by Design you are aware that you agree to fully accept all known and unknown risks, including the potential risk of exposure to respiratory illnesses such as the coronavirus (COVID-19). The coronavirus may be transmitted via exhaled respiratory droplets, and may be transmitted between persons or surfaces. Although we regularly sanitize our equipment and are using necessary cleaning methods, you understand that you may be exposed to the coronavirus or its symptoms through no fault of Fitness by Design or our employees. Known coronavirus symptoms include fever, coughing, shortness of breath, pneumonia, kidney failure, and may include other symptoms, stroke or even death (collectively “Symptoms”). You understand and agree that you will hold us harmless and you will not hold us liable for any real or perceived Symptoms of COVID-19 or any other disease, illness, or condition, nor for exacerbating any existing symptoms, and you fully agree to accept all risks of entering the facility, using the equipment, working with personal trainers, attending classes, and/or interacting or being exposed to other clients (members).
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I understand
I have read this Release and Terms of Agreement and I understand all of its terms. I sign it voluntarily and with full knowledge of its significance.
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Yes
Date
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MM
DD
YYYY
Electronic Signature Consent
*
If you are under the age of 18, PARENT OR GUARDIAN MUST SIGN FOR YOU.
By checking here you are consenting to the use of your electronic signature in lieu of an original signature on paper. You have the right to request that you sign a paper copy.
Re-Type Name (Electronic Signature)
*
Please type name to acknowledge that you have read, and accept, these terms. PARENT OR GUARDINAN MUST SIGN IF UNDER THE AGE OF 18.
Thank you!