Girlfriends Dance Party

Participant Release and Knowledge of Agreement(Required)

I wish to participate in the exercise and training program offered by Northwest Personal Training (NWPT). I understand there are inherent risks in participating in a program of strenuous exercise; consequently, I have been examined by a physician of my choice and have obtained his/her approval for my participation in a fitness program within sixty (60) days of the date set forth below. No change has occurred in my physical condition since the date such approval was given which might affect my ability to participate in the fitness program. If a physician has not examined me, I agree to see a physician within sixty (60) days of the date set forth below to obtain his/her approval for my participation in a fitness program. If I choose not to see a physician prior to beginning a fitness program, I do so strictly at my own risk and against recommendation of NWPT. I also agree to provide NWPT with my physician’s contact information so that NWPT may receive direct clearance and program recommendation/limitations from my physician. I further agree that NWPT and McMillan Active Group Inc shall not be liable or responsible for any injuries to me resulting from my participation in the fitness program (whether at home, at the training studio, outdoors, or at a corporate, commercial, residential or other fitness facility), and I expressly release and discharge NWPT, McMillan Active Group Inc., its owners, employees, agents and/or assigns from all claims, actions, judgments and the like which I or my heirs, executors, administrators or assigns may have or claim to have as a result of any injury or other damage which may occur in connection with my participation in the fitness program. This Release shall be binding upon my heirs, executors, administrators, and assigns.

I have read, understand and agree to this section

Participant Release and Knowledge of Agreement(Required)

I understand that NWPT and McMillan Active Group, Inc. will make every reasonable effort to preserve the privacy of the information contained in this Client Information Questionnaire. I further agree that NWPT and McMillan Active Group, Inc shall not be liable or responsible to me for any inadvertent disclosure of the information contained in the Client Information Questionnaire and I expressly release and discharge NWPT, McMillan Active Group, Inc., its owners, employees, agents and/or assigns from all claims, actions, judgment and the like which I or my heirs, executors, administrators or assigns may have or claim to have as a result of any damage which may occur in connection with disclosure of private information contained in the Client Information Questionnaire. This release shall be binding upon my heirs, executors, administrators and assigns.

I have read, understand and agree to this section(Required)

Participant Release and Knowledge of Agreement(Required)

I certify that the answers to the questions outlined on the PAR-Q form are true and complete to the best of my knowledge. I acknowledge that medical clearance is requested if I have answered “Yes” to any of the questions on the PAR-Q form. I understand and agree that it is my responsibility to inform all employees of any conditions or changes in my health, now and ongoing, which might affect my ability to exercise safely and with minimal risk of injury.

I have read, understand and agree to this section(Required)

Participant Release and Knowledge of Agreement(Required)

I understand that I am not obligated to perform nor participate in any activity that I do not wish to do, and that it is my right to refuse such participation at any time during my training sessions. I understand that should I feel lightheaded, faint, dizzy, nauseated, or experience pain or discomfort, I am to stop the activity and inform my Personal Trainer, Group Fitness Instructor, or alternate staff.

I have read, understand and agree to this section(Required)

Participant Release and Knowledge of Agreement(Required)

I understand the results of any fitness program cannot be guaranteed and my progress depends on my effort and cooperation in and outside of the sessions.

I have read, understand and agree to this section(Required)

Participant Release and Knowledge of Agreement(Required)

I understand that during a Personal Training or Group Training session, my trainer/instructor may have to touch my muscles or joints to correct alignment and/or to focus my concentration on a particular muscle area to be targeted. If I feel uncomfortable or experience any type of discomfort with this form of touch, I will immediately request that it be discontinued.

I have read, understand and agree to this section(Required)

Participant Release and Knowledge of Agreement

I understand that NWPT photographs many of their client events/sessions and I provide NWPT the absolute right and permission to use these pictures/images for any lawful promotional, advertising or marketing purpose.

I have read, understand and agree to this section

I have read this Release and Terms of Agreement and I understand all of its terms. I sign it voluntarily and with full knowledge of its significance.

Client Signature(Required)

By typing your name in this box, you are agreeing to this participant waiver, release and knowledge of agreement

Date

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Guardian's Signature

Required for clients 17 years old and younger

Date

MM slash DD slash YYYY

This field is for validation purposes and should be left unchanged.

Girlfriends Dance Party

PAR-Q FORM

Please Mark YES or No to the following: