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4Balance Fitness 
1200 Woodruff Rd. suite A-12
Greenville, SC 29607

Coaching and Training- The 4B Basic  

Includes:

 

• Movement Assessment

• 60-minute Movement Test w/ Personal Coach

• Work Capacity Test

• Unlimited Facility Access

• 1-on-1 Personal Coach

• Individualized Program

• TrueCoach Mobile App

• Floor Coach

• Movement, Nourishment, Lifestyle Prescriptions

• Injury Rehab/Prehab

• 2 NORMATEC Sessions

I Agree

 

Automatic Payment Authorization:

I hereby authorize Trainer/4Balance Fitness, to charge to my Visa/MasterCard/Discover/American Express Credit Card or Bank Account Number for any and all payments due and/or overdue to Trainer/4Balance Fitness Corporation. I further authorize my credit card company or bank to make payment(s) to Trainer/4Balance Fitness by method(s) indicated above and to post it on my account.

 

Promise to Pay: Client promises to pay 4Balance Fitness total consecutive payments according to the payment schedule shown above. Each payment will be debited 1st of each month from date of first auto debit. Any and all changes to the contract must be in writing and signed by client and 4Balance Fitness. NOW THEREFORE, in consideration of the execution of said contract by client and as a material inducement to client to execute said contract, guarantor(s) hereby jointly, severally, unconditionally and irrevocably guarantee the prompt payment by client of all training dues and other sums payable by client under said contract and the faithful and prompt performance by client of each and every one of the terms, conditions and covenants of said contract to be kept and performed by client. This guaranty shall not be released modified or effected by the failure or delay on the part of the client to enforce and of the rights or remedies of 4Balance Fitness under said contract.

I acknowledge this with my initials:


 

Automatic Renewal: The contract will automatically renew until canceled as described in the cancellation policy.  

I acknowledge this with my initials:


 

Cancellation Policy: Client must give notice of cancellation in writing and in person by official Cancellation notice (obtained from 4Balance Fitness) of no less than 30 days. This policy applies to all contracts. If for any reason there is a contract cancellation before expiration of the contract, the client must pay the full amount of monthly dues for the duration of the contract as an early cancellation penalty. Trainer reserves the right to cancel contract at any time. If trainer cancels contract, any cancellation fees will be voided and not owed to client. For private contracts; there is a minimum of 24 hours notice required before canceling a session or Client will be charged. In the case for injury or medical leave, client is responsible for paying dues for the duration of the contract. Credit will be issued pending doctor approval for time missed upon notification.

I acknowledge this with my initials:


 

WAIVER, RELEASE AND ASSUMPTION OF RISK FORM

Please read the following information carefully. This Wavier, Release and Assumption of Risk Form is an important legal document. It explains the risks you are assuming by beginning or engaging in an exercise/training program with 4Balance Fitness. Prior to printing your name below and executing this Wavier, Release and Assumption of Risk Form, it is critical that you thoroughly read and fully understand it terms.

 

Waiver, Informed Consent, and Covenant Not to Sue

I have voluntarily decided to participate in, at my own risk, a program of physical exercise under the direction of Fitness Ninja, LLC (4Balance Fitness), which will include, but may not be limited to, weight and/or resistance training, cardio workouts, and nutritional conditioning. In consideration of my being permitted to use the facilities, programs, and classes, and 4Balance Fitness agreement to instruct, assist, and train me, I do here and forever release and discharge and hereby hold harmless 4Balance Fitness and its respective officers, directors, agents, heirs, assigns, contractors, and employees from any and all claims, demands, damages, rights of action or causes of action, present or future, arising out of or connected with my participation in this or any exercise/training programs by 4Balance Fitness and the use of its facilities including for any injuries resulting therefrom. THIS WAIVER AND RELEASE OF LIABILITY INCLUDES, WITHOUT LIMITATION, INJURIES WHICH MAY OCCUR AS A RESULT OF (1) EQUIPMENT THAT MAY MALFUNCTION OR BREAK (2) ANY SLIP, FALL, DROPPING OF EQUIPMENT AND (3) 4BALANCE FITNESS NEGLIGENT INSTRUCTION OR SUPERVISION. I FURTHER AGREE NOT TO SUE OR MAKE ANY CLAIM OF ANY NATURE WHATSOEVER RELATING TO OR ARISING OUT OF MY PARTICIPATION IN ANY PROGRAMS OF 4BALANCE FITNESS OR USE OF ITS FACILITIES/EQUIPMENT IN ANY COURT, AGENCY, OR OTHER FORUM OR PROCEEDING AGAINST ANY INDIVIDUAL OR ENTITY WHOM I HAVE RELEASED AND AGREED TO HOLD HARMLESS.

I Agree

 

Assumption of Risk

 

I recognize that exercise might be difficult and strenuous and that there could be dangers inherent in exercise for some individuals. I acknowledge that the possibility of certain unusual physical changes during exercise does exist. These changes include abnormal blood pressure; fainting; disorders in heartbeat; heart attack; and, in rare instances, death.

 

I am aware that anyone who smokes; has ever had elevated blood pressure; is over 45 (men) or 55 (women) years of age; presently does not exercise; has ever had cardiac (heart) problems; is overweight; has diabetes; has a family history of cardiovascular problems; is susceptible to or has ever had orthopedic problems; or is pregnant, is more at risk while exercising. I understand that I should consult with my personal physician before I begin or continue any exercise program. I also understand that I must have a physicians consent and/or have my physician identify any limitations on my exercise that I may have if any of these conditions exist.

 

I understand that as a result of my participation in an exercise program, I could suffer an injury or physical disorder that could result in my becoming partially or totally disabled and incapable of performing any gainful employment or having a normal social life.

 

I acknowledge and agree that I assume the risks associated with any and all activities and/or exercises in which I participate.

 

I acknowledge and agree that no warranties or representations have been made to me regarding the results I will achieve from this program. I understand that results are individual and may vary.

I Agree

I ACKNOWLEDGE THAT I HAVE THOROUGHLY READ THIS CONTRACT, WAIVER, RELEASE AND ASSUMPTION OF RISK FORM, FULLY UNDERSTAND ITS TERMS, UNDERSTAND THAT I HAVE GIVEN UP SUBSTANTIAL RIGHTS BY SIGNING IT, AND HAVE SIGNED IT FREELY AND VOLUNTARILY WITHOUT ANY INDUCEMENT, ASSURANCE, OR GUARANTEE MADE TO ME. BY SIGNING THIS DOCUMENT, I AM WAIVING ANY RIGHT I OR MY SUCCESSORS MIGHT HAVE TO BRING A LEGAL ACTION OR ASSERT A CLAIM AGAINST FITNESS NINJA, LLC FOR ITS NEGLIGENCE OR THAT OF ITS EMPLOYEES, AGENTS, OR CONTRACTORS. I INTEND MY SIGNATURE TO BE A COMPLETE AND UNCONDITIONAL RELEASE OF ALL LIABILITY TO THE GREATEST EXTENT ALLOWED BY LAW.

BY SIGNING BELOW, EXECUTION OF THESE TERMS WILL BEGIN AND I ACKNOWLEDGE THAT I UNDERSTAND THAT I AM ENTITLED TO HAVE AN ATTORNEY OF MY OWN CHOOSING REVIEW THIS CONTRACT, WAIVER, RELEASE AND ASSUMPTION OF RISK FORM.

 

Participants signature (parent/guardian if under 18 years old)

October 30, 2020

 

First Member's Name

First Name*

Middle Name

Last Name*

Phone*
First Member's Date of Birth*
First Member's Signature*
Second Member's Name

First Name*

Middle Name

Last Name*
Second Member's Date of Birth*
Third Member's Name

First Name*

Middle Name

Last Name*
Third Member's Date of Birth*
Fourth Member's Name

First Name*

Middle Name

Last Name*
Fourth Member's Date of Birth*
Fifth Member's Name

First Name*

Middle Name

Last Name*
Fifth Member's Date of Birth*
Sixth Member's Name

First Name*

Middle Name

Last Name*
Sixth Member's Date of Birth*
Seventh Member's Name

First Name*

Middle Name

Last Name*
Seventh Member's Date of Birth*
Eighth Member's Name

First Name*

Middle Name

Last Name*
Eighth Member's Date of Birth*
Ninth Member's Name

First Name*

Middle Name

Last Name*
Ninth Member's Date of Birth*
Tenth Member's Name

First Name*

Middle Name

Last Name*
Tenth Member's Date of Birth*
Parent or Guardian's Email Address

Email*

Confirm Email*
Check to receive information, news, and discounts by e-mail.
Member's Address

Street address, P.O. box, company name, c/o *

Apartment, suite, unit, building, floor, etc.

Country *

City *

State/Province *

Zip Code *
Emergency Contact

Emergency Contact's Name *

Emergency Contact's Phone Number *
Driver's License / ID Card

Driver's License / ID Card Number *

Issuing State *
Commitment

Contract Length 

Month to Month


What brought you to us at 4B?*
Improve Flexibility
Improve Health
Improve Strength
Lose Weight
Stress Release
How did you find us?*
Internet Search
Facebook
Instagram
YouTube
Referral
Other

Who's referral should we thank for your business? *

4B Coach who helped you *
Please inform us on your health
Any pre-existing conditions or health issues?*
No
Yes

If answered yes, please list all pre-existing conditions or health issues
Any past or present injuries?*
No
Yes

If answered yes, please list injuries below.
Are you on any medications?*
No
Yes

If answered yes, please list medications below.
Payment Options
Choose One:
Month to Month $197/month
6 Month Agreement $147/month
6 Month Paid In Full $794 (10% Discount)
Automatic Payment Authorization

I hereby authorize Trainer/Fitness Ninja, LLC to charge my Visa/MasterCard/ Discover/ American Express Credit Card or Bank Account Number for any and all payments due and/or overdue to Trainer/Fitness Ninja, LLC. I further authorize my credit card company or bank to make payment(s) to Trainer/4Balance Fitness by method(s) indicated above and to post it on my account text

Type Of Payment
Visa
Mastercard
American Express
Discover

Card Number *

Expiration Date *

CVV CODE *

Each payment will be debited the 1st of each month unless otherwise stated below. A $25 late fee will be added for payments that are charged back/declined. 

Amendments or Billing Instructions

List any agreed upon amendments or type N/A *
Parent(s) or court-appointed legal guardian(s) must sign for any participating minor (those under 18 years of age) and agree that they and the minor are subject to all the terms of this document, as set forth above.
Parent or Guardian's Name

First Name*

Middle Name

Last Name*

Phone*
Parent or Guardian's Date of Birth*
Parent or Guardian's Signature*
Electronic Signature Consent*
 By checking here, you are consenting to the use of your electronic signature in lieu of an original signature on paper. You have the right to request that you sign a paper copy instead. By checking here, you are waiving that right. After consent, you may, upon written request to us, obtain a paper copy of an electronic record. No fee will be charged for such copy and no special hardware or software is required to view it. Your agreement to use an electronic signature with us for any documents will continue until such time as you notify us in writing that you no longer wish to use an electronic signature. There is no penalty for withdrawing your consent. You should always make sure that we have a current email address in order to contact you regarding any changes, if necessary.


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