Informed Consent Form
Objectives:
I understand that my personal fitness program is individually tailored to meet the goals and objectives agreed upon by Special Fitness LLC and myself. I understand, however, that my personal trainer cannot guarantee that I will accomplish the goals that are established.
Description of Fitness Program:
I understand that my exercise program will involve participation in a number of types of fitness activities. These activities will vary depending upon my established objectives, but may include:
Aerobic activities including, but not limited to, walking/jogging/running, stationary aerobics, jump rope, playing catch, agility cone drills, agility ladder, circuit training, and step exercises.
Muscular endurance and strength building exercises including, but not limited to, the use of resistance bands, light dumbbells, pushups, and other light muscular exercises.
Other activities selected by my personal trainer and agreed upon by me.
Selected physical fitness and body composition tests.
Potential Risks:
My personal trainer has explained that no exercise program is without inherent risks and that, regardless of the care taken by my personal trainer, he/she cannot guarantee my personal safety. For example, when one induces cardiovascular stress through activity, injuries can range from occasional minor injury (e.g. pulled muscles, muscle soreness) to infrequent serious injury (e.g. heart attack, stroke, or other cardiovascular accidents) to the very rare catastrophic incident (e.g. death, paralysis). Likewise, I know that engaging in muscular endurance, strength building, and other fitness activities occasionally results in minor injuries (e.g. bruises, musculo-skeletal strains and sprains), infrequently, more serious injuries (e.g. muscle tears, herniated disks, torn rotator cuffs), and very rarely, catastrophic injury (e.g. death, paralysis). I realize that when participating in any exercises or conditioning activity, there is always a possibility that minor injuries, major injuries, or catastrophic injury/death may occur.
Potential Benefits:
I understand that a regular exercise program has been shown to have definite benefits to general health and well-being. I know that some of the physiological benefits of a regular exercise program can include loss of weight, reduction of body fat, improvement of blood lipids, lowering of blood pressure, improvement in cardiovascular function, reduction in risk of heart disease, improved strength and muscular endurance, improved posture, and improved flexibility. I further understand that regular exercise can have psychological benefits, often improving one’s outlook as well as relieving tension and stress.
Client’s Responsibilities:
I understand that it is my responsibility to:
Cancel a scheduled session at least 48 hours prior to the scheduled appointment. If I fail to do this, I forfeit the session without a refund. At the trainer’s discretion, certain instances will be considered for exclusion in the case that they are unavoidable emergencies and that particular session is rescheduled in a timely fashion suited to the trainer's availability. Trainer availability for rescheduling is not guaranteed.
Wear appropriate attire for exercise fitness.
Notify Special Fitness for the trainer if there is a relocation for set appointments.
Take seriously and attend to all scheduled training appointments. To the best of my ability I will comply with all of the program components in an effort to assist in the achievement of my goals.
Inform the trainer if there are any activities with which I do not feel comfortable.
Cease exercise and report promptly any unusual feelings (e.g. chest discomfort, nausea, difficulty breathing, apparent injury) during the exercise program.
