CONSENT FORM and release of liability waiver

General Statement of Program Objectives and procedures: I understand that this personal 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 machine, 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 the reaction of the heart, lung, blood vessels as well as other systems to exercise cannot always be predicted with accuracy. I know there is a risk of certain abnormal changes occurring during the following exercise, which include abnormalities of blood pressure or heart attacks as well as other side effects. Use of weight lifting equipment, and engaging in heavy body calisthenics may lead to musculoskeletal strains, pain and injury if adequate warm-up, gradual progression, and safety procedures are not consistently followed. I understand that personal trainer (seller) shall not be liable for any damages arising from personal injuries sustained by client (buyer) while and during and/or from a personal training program does so at his/her own risk. Client (buyer) assumes full responsibilities for any injuries or damages which may occur during and/or after training. Release of Liability: You are encouraged to obtain a physical examination from a doctor before participating in any exercise activity. I agree that if I engage in any physical exercise or activity, I do so entirely at my own risk. Any recommendations for changes in diet including the use of supplements are entirely your responsibility and you should consult a doctor prior to undergoing any dietary or food supplement changes. I agree that I am voluntarily participating in these activities and assume all risks of injury, illness or death. In full consideration of the above mentioned risks and hazards and in full consideration of the fact that I am willing and voluntarily participating in the fitness and/or nutrition program made available at Equilibrium, I hereby waive, release and discharge personal trainers/coaches of Equilibrium, Equilibrium, agents, and its employees and volunteers of any kind, related to, arising from, or in any way connected with my participation in a physical fitness and/or nutrition program. This waiver and release of liability includes, without limitation, all injuries which may occur as a result of: (a) your participation in any activity, personal training session, online training program and (b) instruction, training, supervision, massage or any dietary recommendations by your personal trainer/lifestyle coach. I understand and warrant, release and agree that I am in good physical condition and that I 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 the Application Form). I state that I have had a recent physical check up and have my personal physician’s permission to engage in aerobic and/or anaerobic conditioning. Description of Potential Benefits: I understand that a program of regular exercise for the heart, lungs, 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 decrease in heart disease. Confidentiality and Use of Information: I have been informed that the information which is obtained in this personal fitness training program will be treated as privileged and confidential and will consequently not be released or revealed to any person, to the use of any information which is not personally identifiable with me for research and statistical purposes so long as same does not identify my person or provide facts which could lead to my identification. Any other information obtained, however, will be used only by the program staff to evaluate my exercise status or needs. Inquiries and Freedom of Consent: I have been given an opportunity to ask questions as to the procedures.