Register for on-line personal training

First Name:    *
Last Name:    *
e-mail:    *
Phone (primary):    *
Phone (alternate):  
Date of Birth:   - -  *
Sex:    *
Emergency Contact Name:    *
Relationship:  
Emergency Contact Phone 1:    *
Emergency Contact Phone 2:  
Waiver and consent:  

I have enrolled in a program of strenuous physical activity including, but not limited to, aerobic exercise, weight training, and the use of various aerobic-conditioning machinery offered by Hone, Train, Focus, Unleash Personal Training (referred to, from this point forward, as HTFU). I also understand that some of these activities will occur outside in natural surroundings; therefore I will take care to be prepared for the day's weather conditions.

I hereby affirm that I am in good physical condition and do not suffer from any disability that would prevent or limit my participation in the exercise program. I understand that there are inherent risks in participating in a program of strenuous exercise.

In consideration of my participation in HTFU's exercise program, I, for myself, my heirs and assigns, hereby release HTFU (its agents, officers, principals, employees and owners), from any claims, demands and causes of action arising from my participation in the exercise program.

I fully understand that I may injure myself as a result of my participation in HTFU's exercise program and I, hereby release HTFU from liability now or in the future including, but not limited to, heart attacks, muscle strains, pulls or tears, broken bones, shin splints, heat prostration, knee/lower back/foot injuries, and any other illness, soreness, injury, or even death, however caused, occurring during or after my participation in the exercise program.

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 if there are any changes in my medical situation.

I understand that I am not obliged to perform or participate in any activity that I do not wish to do, and that is my right to refuse such participation at any time. I understand that should I begin to feel light-headed, faint, dizzy or nauseated, I should report the feeling immediately to my Personal Trainer.

I understand that the results of any fitness program cannot be guaranteed and that my progress depends on my effort and cooperation in and outside of the prescribed exercise sessions.

I understand that during in-person training sessions, my Personal Trainer may have to use touch to correct my alignment and/or to focus my concentration on a particular muscle area to be targeted. If I feel uncomfortable I will immediately request that my trainer discontinue touch training.

 I accept and agree to the terms and conditions of this waiver.

Enrollment Term:  



Payment Option:    
   

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Your Training Preferences
One-on-one personal training
Small group personal training (you and a few friends)
On-line personal training (program design for self directed workouts)
Boot camp style circuit training (10-15 people)
Women-only boot camp