Informed Consent Agreement
Description of the Exercise 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, the use of treadmills, stationary bicycles, step machines, rowing machines, ellipticals, running roads/trails, plyometric stations/equipment, and medicine balls.
muscular endurance and strength building exercises including, but not limited to, the use of free weights, weight machines, physioballs and other exercise apparatus; plyometric stations/equipment, and body weight exercises.
yoga and/or stretching and mobility exercises.
Description of Potential Risks
The 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. 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.
I understand that yoga, stretching and mobility exercises includes physical movements as well as an opportunity for relaxation, stress reduction and relief of muscular tension. If I experience any pain or discomfort, I will listen to my body, discontinue the activity, and ask for support from the instructor. I assume full responsibility for any and all damages, which may incur through participation.
Description of Potential Benefits
I understand that a regular exercise program has been shown to have definite benefits to general health and wellbeing. Some of the physiological benefits of a regular exercise program can include change in body composition, 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 and feeling of well-being, as well as relieving tension and stress.
I understand that it is my responsibility to:
fully disclose any health issues (including diabetes, heart problems, seizures, and asthma) or medications that are relevant to participation in a strenuous exercise program.
inform the trainer if there are 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
clear my participation with my physician
In agreeing to this exercise program, I,:
Acknowledge that my participation is completely voluntary, and that I may be dismissed from the program at the sole discretion of the trainer.
Understand the potential physical risks involved in the exercise program and believe that the potential benefits outweigh those risks.
Give consent to physical touch that may be necessary to ensure proper technique and body alignment. I also reserve the right to deny consent at any time, and will clearly make this known to the personal trainer.
Understand that the achievement of health or fitness goals cannot be guaranteed.
If I am pregnant, become pregnant, or am post-natal or post-surgical, my signature verifies that I have my physician's approval to participate.
Acknowledge that I am in good physical condition, have no impairment which might prevent participation in such activities, and have been advised to consult a physician prior to beginning this program.
Have been advised to cease exercise immediately if I experience unusual discomfort and feel the need to stop.
I have read and understand the above agreement. I have been made fully aware of, and understand, the potential risks involved in this physical fitness program. I hereby consent to those risks and am freely and voluntarily participating in this program. I hereby agree to irrevocably release and waive any claims that I have now or may have hereafter against Meghan Brown Personal Training, LLC. Finally, I am freely signing this agreement.