Please Fill Out Personal Consent Form For Personal Training and or Kickboxing Training Consent Form Full Name * If signing for a minor state minor name If signing for a minor state minor relationship If signing for a minor state minor age Address * Address Address Address City City State/Province State AlabamaAlaskaArkansasArizonaCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyoming State/Province Zip/Postal Zip/Postal Your Email * Confirm Your Email * Phone * Emergency Contact Name * Emergency Contact Phone Number * Consent To/Read and Agree To Consent * GENERAL STATEMENT OF PROGRAM OBJECTIVE AND PROCEDURES: I understand that this physical fitness program includes exercises to build the cardiorespiratory system heart and lungs the musculoskeletal system muscle endurance strength and flexibility and to improve body composition decrease of body fat and individuals needing to lose fat with an increase in weight of muscle and bone. Exercise may include aerobic activities treadmill walking running bicycling riding rowing machine exercise group aerobic activity swimming and other aerobic activities calisthenic exercises weightlifting to improve muscular strength and endurance and flexibility exercises to improve joint range of motion. DESCRIPTION OF POTENTIAL RISKS: I understand that the reaction of the heart, lung, and blood vessel system to exercise cannot always be predicted with accuracy. I know there is a risk of certain abnormal changes occurring during it or following exercise which may include abnormal Lisa blood pressure or heart attacks use of the weightlifting equipment and engaging in heavy body calisthenics may lead to muscular sac skeletal strange pain of injury of adequate warm-up gradual progression and safety procedures are not followed. I understand that the seller shall not be liable for any damages arising from a personal injury sustained by the buyer while and during the personal training program. They are using the exercising equipment during the personal training program does so Ed his her own risk buyer assumes full responsibility for any injuries or damages which may occur during the training. I hereby fully and forever release and discharge seller it’s the signs and agents from all claims demands damages rights of action present and future therein. I understand and warrant release and agree that I am in good physical condition as they have no disability impairment or ailment preventing me from engaging in active or passive exercise that will be detrimental to heart safety or comfort or physical condition if I engage or participate other than those items fully discussed on health history form. I state that I have had a recent physical check-up and have my personal physicians permission to engage in aerobic and or anaerobic conditioning. DESCRIPTION OF POTENTIAL BENEFITS: I understand a program of regular exercise for the heart longs muscles and joints has many benefits associated with it. These may include a decrease in body fat improvement in blood fats and blood pressure improvement in physiological function and a decrease in risk in heart disease. I have read the foregoing information and understand it. Any questions which may have occurred to me that have been answered to my satisfaction. If you agree to the terms of the consent form please check "I AGREE" * I AGREE I DO NOT AGREE Type Your Name To Validate This Form * Draw your Signature * signature keyboard Clear CAPTCHA Submit
