Informed Consent and Waiver
Today's Date: June 24, 2018
In consideration of entry into training with Legitimate Movement (Structure Strength and Conditioning, LLC) and Body Work with Kevin Perrone, I the undersigned intend to be legally bound and do hereby agree to be legally bound for myself and for all successors in interest I may have, by this Contract, Waiver and Release of Liability, and hereby agree to hold harmless and indemnify Legitimate Movement, Structure Strength and Conditioning, LLC, and Kevin Perrone, as well as all officers, members, employees, assistants, volunteers, assigns, or agents of any type whatsoever acting on or in behalf of the aforementioned entities and persons, against any claims for damages or other claims for injuries or losses of any kind suffered by me or any others, directly or indirectly, arising out of any practice, instructions, or other activity related to this program as well as participation in this program or traveling to or from this program or any other activity related to this program.
I understand that the activities, exercises and training methods to be taught may not be appropriate for all people and may, in some cases, cause injury or aggravate existing injuries. I certify that I am physically able to participate in this activity and will further hold Legitimate Movement, Structure Strength and Conditioning, LLC, and Kevin Perrone, as well as any and all officers, members, employees, assistants, volunteers, assigns, or agents of any type whatsoever acting on or in behalf of the aforementioned entities and persons, harmless for any injury sustained in the course of this training due to any physical defect or condition that I may have, whether now known or hereinafter discovered. I further acknowledge that in consideration for this training, this release shall not expire and shall be considered effective in perpetuity. I also understand that all exercises, training methods and concepts are to be used at my own risk and that the aforementioned trainers and entities assume no responsibility for my actions.
I acknowledge if I am uncomfortable with any activity, exercise or training program within the course that I may immediately state so, and that it is my right and responsibility to remove myself from the situation immediately and that I am encouraged to do so.
I have understood all that is expressed in this waiver and release of liability, and I certify that I am of sound judgment, legally competent to agree to this waiver.
Additionally, I certify that I am / am not (check one) eighteen years of age or older, or a legally emancipated adult.
PAR-Q & Medical Clearance:
A medical clearance form is required of all participants who answer "yes" to any of the seven PAR-Q questions. Note: Personal training and Body Work staff reserve the right to require medical clearance from any client they feel may be at risk.
All personal training sessions are one hour. At request, personal training sessions may also be 30 minutes in length and will count for half of a session (not applicable on a Personal Training Introduction Purchase, Single Session purchase or Partner package purchases). Small group class sessions will be one hour and 15 minutes in length. Body Work sessions with Kevin Perrone will vary in length of time - as scheduled individually.
Come prepared to each training session in proper workout attire (shorts, gym pants, T-shirt). Shoes are optional and left up to the discretion of the participant. Participants arriving unprepared for their training session may lose the session. For Body Work sessions, wear proper attire as discussed with Kevin Perrone.
Clients are responsible for arriving on-time to their sessions.
Trainers are obligated to wait only 10 minutes. After 10 minutes, the trainer is not required to lead the remaining time of the session and the session may be lost.
For small group classes, attendees are expected to arrive before the designated start time. Please respect your coaches and fellow members by not being late.
Clients are asked to call 24 hours in advance of the scheduled training session. You will be charged for appointments cancelled with fewer than 24 hours notice. Failure to contact your trainer will result in a session loss. Missed sessions due to trainer absence will be rescheduled for 10 days prior to or following a missed session.
Class Reservation Policy:
For small group classes, your spot must be reserved via the designated software reservation system (currently Zen Planner) no later than one hour prior to class start time. Please be considerate of your fellow members by only reserving spots for classes you intend to attend.
Body Work Sessions:
I understand that Kevin Perrone is a Licensed Massage and Bodywork Therapist and that any bodywork performed on myself is totally voluntary and may be refused at any time, even if the session has already begun. I understand it is my responsibility to relate any pain or discomfort experienced and that Kevin Perrone intends to work within individual client tolerance. I understand that anything is possible during and following a bodywork session including but not limited to: bruising, pain, swelling, discomfort, emotional or psychological changes, dizziness, and nausea. I understand that all bodywork or massage work is meant to be therapeutic in nature only.
I understand that it is my responsibility to inform Kevin Perrone of all medical issues during the health history interview. I understand that the session is not a replacement for medical evaluation and it is not Kevin Perrone's duty to diagnose any medical conditions. All interactions before, during, and after the session are intended to be informative in nature and are not to replace or supersede any previous or future medical advice.
Any recommendation for changes in diet including the use of food supplements, weight reduction and/or body building enhancement products are entirely your responsibility and you should consult a physician prior to undergoing any dietary or food supplement changes. You agree that you are voluntarily participating in these activities and use of these facilities and premises and assume all risks of injury, illness, or death. I am also not responsible for any loss of your personal property.
I am forewarned that Kevin Perrone will not in any event, provide medical and/or hospitalization insurance for my benefit, and in the event of an injury to my person occurring either as a result of my being on any portion of the location in which a session is being conducted. I will save harmless and keep indemnified Kevin Perrone and his respective trustees, beneficiaries, staff, and officers from and against any and all action claims, costs, expenses or demands, in respect of such injury or injuries, including death, howsoever caused, arising out of or in connection with my use of any facilities or my being on any portion of said premises and notwithstanding that the same may have been contributed to or occasioned by the negligence of Kevin Perrone and his representatives, officers, directors, trustees and or beneficiaries.