top of page
Form

CLIENT INFORMED CONSENT FORM

INFORMED CONSENT FORM

Please fill out the following form in order to participate in our activities.

GENERAL STATEMENT OF PROGRAM OBJECTIVES AND PROCEDURES:

​

Group Training Classes: I understand that the physical fitness program is designed to accommodate multiple individuals with varying goals and fitness levels.

​

I understand that this group training program may include exercises to build the cardio respiratory system (heart and lungs), the musculoskeletal system, (which involves muscular endurance, strength and overall flexibility), and to improve body composition (increasing muscle and bone and decreasing body fat). Exercise includes aerobic activities, such as walking, running, bicycle riding, rowing, group aerobics, swimming and other aerobic activities, weight lifting using dumbbells, machines and other equipment to improve muscular strength and endurance, as well as flexibility exercises to improve joint range of motion.

​

DESCRIPTION OF POTENTIAL RISKS:


I understand that no exercise program is without inherent risks regardless of the care taken by a personal trainer and that my personal safety cannot be guaranteed by my personal trainer. I realise that when participating in any exercises, particularly those that induce cardiovascular stress, there is a slight chance of serious injury (e.g. heart attack, stroke, or other cardiovascular accidents) or catastrophic incident (e.g. death, paralysis). Likewise, I know that engaging in muscular endurance, strength building, and other fitness activities sometimes results in minor injuries (e.g. bruises, musculoskeletal strains and sprains), less frequent, more serious injuries (e.g. muscle tears, herniated disks, torn rotator cuffs), and rarely, catastrophic injury (e.g. death, paralysis).

​

PHOTOGRAPHIC PERMISSION:

​

As part of our ongoing marketing we may take photographs and short video clips during training sessions. Sign here if you consent to having your photograph used for marketing purposes on our website and social media pages.

​

DESCRIPTION OF POTENTIAL BENEFITS:


I understand that a regular exercise program has been shown to have definite benefits to general health and well-being. I know that some of the benefits can include loss of weight, reduction of body fat, improvement of blood lipids, lowering of blood pressure, improvement of cardiovascular function, reduction in the risk of heart disease, improved strength and muscular endurance, improved posture, and improved flexibility.

​

PARTICIPANT RESPONSIBILITIES:

​

I understand that it is my responsibility to fully disclose any health issues or medications that are relevant to participation in a strenuous exercise program. Inform the coach and cease exercise and report promptly

any unusual feelings (e.g. chest discomfort, nausea, difficulty breathing, apparent injury).

​

I have read and understand the above agreement;


I have been able to ask questions regarding any concerns I might have; I have had those questions answered to my satisfaction; and I am freely signing this agreement.

I give permission for photographs / videos to be used

Thanks for submitting!

bottom of page