Friday, September 10, 2010

I’m Coming Back For More!

Update Information

Please update any address or contact information that has changed since you started with us.
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Address
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Emergency Contact & Phone

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Health & Medical History

Has any part of your health history changed since you began training with us?
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If Yes, please describe
Do you have any other health, medical or injury conditions that your trainer should be aware of?
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If Yes, please describe
Do you know of any other reason you should not exercise or increase your physical activity?
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If Yes, please describe

Approval of Health & Medical History

I certify that I understand the forgoing questions and my answers are true and complete. I also understand that if this information changes in any way in the future, it is my responsibility to notify my trainer, and that I assume the risk for any changes in my medical condition that might affect my ability to exercise.
I acknowledge that it is recommended to consult a physician prior to starting any health/fitness/nutrition program, and that only a qualified health care provider is able to diagnose and prescribe treatment for specific health conditions. If I choose not to obtain a physician’s consent, I hereby agree I am doing so solely at my own risk.
I agree to the above statement
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Digital Signature

By typing your name into this field, you are hereby providing a digital signature
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Upon submitting registration, you will be forwarded to another page to complete payment options. This may take 1-2 minutes. If you have challenges with this form, please let us know.