Personal Training Contract & Policies

Name(Required)

Date(Required)

The training sessions will take place on(Required)

Monday

Tuesday

Wednesday

Thursday

Friday

Saturday

Training Time

Please be ready to begin each training session at your scheduled appointment time. Training sessions are not extended if you are late. Should you, the client, wish to reschedule an appointment, I will do my best to accommodate your request. If the request is placed less than 24 hours prior to appointment, you will be charged for the appointment.
**NOTICE Contracts expire 6 months after purchase. This agreement cannot be canceled and is NON-REFUNDABLE. All contracts can be transferred. Contracts can be extended for injuries, pregnancy, and job loss ONLY.

Client Signature(Required)

Date(Required)

Phone(Required)

Email(Required)

Address(Required)

Street Address Address Line 2 City State ZIP Code

Trainer's Name

Consent and Assumption Of Risk For Personal Trainer and Evaluation and Physical Fitness Programs

Name(Required)

Agreement(Required)

I DESIRE TO USE THE SERVICES OF A PERSONAL TRAINING PROGESSIONAL provided by Laser Sharp Fitness. I understand that working with a personal fitness professional will involve a physical fitness program which may include testing procedures (such as body fat %, circumference, cardiorespiratory, strength, flexibility, and other such testing procedures), aerobic activities (such as treadmill walking/running, bicycle riding, rowing machine exercise, group aerobic activity, swimming and other such activities), calisthenics and weight lifting to improve muscular strength and endurance, and flexibility exercises to improve joint range of motion. I understand that the reaction of the heart, lungs and blood vessel system to such exercise cannot always be predicted with accuracy. I know that during or following exercise there is a risk that I may experience abnormal blood pressure or heart rate, ineffective functioning of the heart, and in rare instances, heart attacks. Use of the weightlifting equipment, and engaging in heavy body calisthenics, can lead to musculoskeletal strains, pain and injury. I also understand that a program of regular exercise for the heart and lungs, muscles, and joints, has many associated benefits. These may include a decrease in body fat, improvement in blood fats and blood pressure, improvement in psychological function and a decrease in risk of heart disease. The amount and degree of benefits experienced will be relative to the adherence of an exercise program based on prescribed amounts of intensity, duration, frequency, progression and types of activity. I have read the above information and I understand the potential risks and benefits of working with a personal fitness professional and I voluntarily agree to assume such risks. In consideration of Laser Sharp Fitness providing me with a personal fitness professional, I, for myself, my heirs and assigns, hereby release and hold harmless Laser Sharp Fitness, and the personal fitness professional from any claims, demands and causes of action of any kind. Further, I hereby release Laser Sharp Fitness and the personal fitness professional from any liability now and in the future relating to any illness, soreness, or injury, however caused, occurring during or after my participation in the exercise program.

I agree.

Signature(Required)

Date(Required)

Health History Questionnaire

This Form and Your Confidentiality
This health history form is your opportunity to provide information that will assist our personal fitness professionals in evaluating your current level of health fitness. Laser Sharp Fitness will maintain this form and the information you provide in a manner that assures your confidentiality. Any information you provide will be available only to the personal fitness professionals of Laser Sharp Fitness and will be used solely in conjunction with planning and developing health and fitness programs

Name(Required)

Date(Required)

Home Phone(Required)

Cell Phone(Required)

Date of Birth / Age(Required)

Height(Required)

Weight(Required)

Address(Required)

Street Address Address Line 2 City State ZIP Code

Employer

Employer Phone Number

Primary Physician’s name:(Required)

Primary Physician’s Phone Number(Required)

Emergency Contact’s Name(Required)

Emergency Contact’s Phone Number(Required)

Emergency Contact Relationship

Health History

Please indicate your history related to each of the following conditions by checking the appropriate box. If you have had any condition in the past, please indicate the date in the appropriate space.

Heart murmur, clicks, or other cardiac findings

Never

Now

Other

Frequent extra, skipped, or rapid heart beats/palpitations

Never

Now

Other

Heart attack, coronary bypass, or other cardiac surgery

Never

Now

Other

Chest pain / angina (especially upon exertion)

Never

Now

Other

Currently pregnant

Never

Now

Other

Diagnosed with high blood pressure

Never

Now

Other

Leg cramps during exercise

Never

Now

Other

Chronic swollen ankles

Never

Now

Other

Varicose veins

Never

Now

Other

Frequent dizziness / fainting /shortness of breath / concussion

Never

Now

Other

Blood clot

Never

Now

Other

Severe arthritis

Never

Now

Other

Orthopedic problem(s) or complaint(s)

Never

Now

Other

Chronic back pain / hernia

Never

Now

Other

Musculoskeletal problem(s) or complaint(s)

Never

Now

Other

Asthma

Never

Now

Other

Cancer

Never

Now

Other

Diabetes

Never

Now

Other

Epilepsy / Seizures

Never

Now

Other

Rheumatic Fever

Never

Now

Other

Scarlet Fever

Never

Now

Other

Bronchitis

Never

Now

Other

Stroke

Never

Now

Other

Pneumonia

Never

Now

Other

Recent surgery, chronic conditions (please describe and give dates)

Other medical problems / considerations, recent illness(es), hospitalization(s), or injury

Current medications / prescriptions

Do you smoke?

Date of last complete medical or physical exam:

Do you know of any medical or health conditions, considerations, or circumstances that might make it dangerous or unwise for you to participate in an exercise program?

Family Health History

Please indicate the number of blood relatives (mother, father, grandparents, brothers, sisters, children) who:

Have had a heart attack prior to age 65

Have had a stroke

Have had or now have diabetes

Have been or are substantially overweight

Signature(Required)

Client Name