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Lifting Weights

TSF NEW CLIENT
PAPERWORK

Here, you will find all the necessary forms and documents to get started with our services. We aim to make the onboarding as smooth as possible, so please take your time to complete all of the forms. If you have any questions, feel free to reach out to us!

HEALTH HISTORY QUESTIONNAIRE

Date of Birth
Day
Month
Year

In case of emergency, whom may we contact?

Personal physician

Personal Past History

Have you had OR do your presently have any of the following conditions?

(Check if Yes)

Family History

Have any of your first-degree relatives (parent, sibling, or child) experienced the following conditions? In addition, please identify at what age the condition occurred.

(Check if Yes)

Activity History

Are you presently employed?
Yes
No
Have you ever worked with a personal trainer before?
Yes
No
Do you participate in a regular exercise program currently?
Yes
No
Intensity
Light
Moderate
Vigorous
Can you currently walk 4 miles briskly
No
If yes, Without fatigue?
Without Fatigue?
Yes
No
Have you ever performed resistance training exercises in the past?
Yes
No

What is the heaviest you have done for the following exercises?

Bench Press

Squat

Deadlift

Do you have injuries (bone or muscle disabilities) that may interfere with exercising?
No
If Yes, Briefly Describe
Do you smoke?
No
If Yes, how much per day and what was your age when you started?

The following questions relate to your current diet (caloric intake) practices.

Do you follow, or have you recently followed any specific dietary intake plan?
No
If Yes, briefly describe the plan and your current feelings about the diet.
Have you ever tried a diet?
No
If Yes, list and briefly describe the diet plan and the challenges you had in adhering with the diet.
Do you snack?
No
If yes, list what you typically snack on and how often you snack. Include brands and serving size if you know. Otherwise describe your snacking habit.

How often do you eat at home cooked meals?

How often do you eat food from a restaurant either fast food or dine-in?

Choose 3 goals, List in order your most important personal health and fitness objectives on how you think we can achieve the goal.


Do you currently have an activity tracker such as Garmin, FitBit, Polar or any other company

24-HR DIETARY RECALL

Please recall and describe all the food and drink you have consumed in the last 24 hours from waking to sleeping. Include all meals, snacks, drinks, “bites”, etc.

EARLY MORNING

MORNING

MIDDAY

AFTERNOON

EVENING

LATE EVENING

BEDTIME (SLEEPING HOURS)

Personal Training Contract/Agreement

Congratulations on your decision to participate in an exercise program! With the help of your strength coach, you greatly improve your ability to accomplish your training goals faster, safer, and with maximum benefits. The details of material provided can be used for a lifetime.


To maximize progress, it will be necessary for you to follow program guidelines during supervised and (if applicable) unsupervised training days. Remember, exercise and healthy eating are EQUALLY important!

During your exercise program, every effort will be made to assure your safety. However, as with any exercise program, there are risks, including increased heart stress and the chance of musculoskeletal injuries. In volunteering for this program, you agree to assume responsibility for these risks and waive any possibility for personal damage. You also agree that, to your knowledge, you have no limiting physical conditions or disability that would preclude an exercise program.


By signing below, you accept full responsibility for your own health and well-being AND you acknowledge and understand that no responsibility is assumed by Bryan Rodriguez (NIE: Y3074658D) or the leaders of the program.


WE THANK YOU FOR PRIORITIZING YOUR HEALTH AND ARE PROUD TO WORK ON YOUR NEW TRAINING PROGRAM TOGETHER!


Date
Day
Month
Year
Date
Day
Month
Year
Date
Day
Month
Year

User’s Representations, Express Assumption of All Risks, and Release of Liability Agreement

Purpose of This Binding Agreement

By reading and signing this document, “You,” the undersigned, sometimes also referred to as “User” or “I,” will agree to release and hold Bryan Rodriguez (NIE: Y3074658D) (“Club” or “We”) harmless from, and assume all responsibility for, all claims, demands, injuries, damages, actions or causes of action to persons or property, arising out of or connected with your use of the Club’s services. The agreement and release is for the benefit of the Club, its employees, agents, independent contractors, other users of the Club. This agreement includes your release of these persons from responsibility for injury, damage, or death to yourself because of those acts or omissions claimed to be related to the ordinary negligence of these persons. This agreement also includes your representations as to important matters which the Club will rely upon.


Representations

The undersigned, You, represent: (a) that you understand that use of the Club services and programs includes an inherent risk of injury to persons and property; (b) that you are in good physical condition and have no disabilities, illnesses, or other conditions that could prevent you from exercising and using the Club’s services without injuring yourself or impairing your health; and (c) that you have consulted a physician concerning an exercise program that will not risk injury to yourself or impairment of your health. Such risk of injury includes, but is not limited to, injuries arising from or relating to use by you or others of exercise equipment and machines, locker rooms, spa and other wet areas, and other Club facilities; injuries arising from or relating to participation by you or others in supervised or unsupervised activities or programs through the Club; injuries and medical disorders arising from or relating to use of the Club’s facilities including heart attacks, sudden cardiac arrests, strokes, heat stress, sprains, strains, broken bones, and torn muscles, tendons, and ligaments, among others; and accidental injuries occurring anywhere in the Club including lobbies, hallways, entrances, stairways, exercise areas, locker rooms, steam rooms, pool areas, Jacuzzis, saunas, and dressing rooms. Accidental injuries include those caused by you, those caused by other persons, and those of a “slip-and-fall” nature. If you have any special exercise requirements or limitations, you agree to disclose them to the Club before using a club’s facilities; and when seeking help in establishing an exercise program, you hereby agree that all exercise and use of the Club’s services and programs are undertaken by you at your sole risk. As used herein, the terms “include,” “including,” and words of similar import are descriptive only, and are not limiting in any manner.


You also acknowledge and represent that you realize and appreciate that access to and use of a club’s facilities during nonsupervised times increases and enhances certain risks to you. You realize that if you use a club during nonsupervised hours, any emergency response to you in the event of need for same may be impossible or delayed.


While we encourage you to use a club’s facility with a partner during nonsupervised times, you may choose to do so without a partner, therefore enhancing and increasing the risks to you as to the provision of first aid and emergency response. You realize that a delay in the provision of first aid and/or emergency response may result in greater injury and disability to you and may cause or contribute to your death.


You do hereby further declare yourself to be physically sound and suffering from no condition, impairment, disease, infirmity, or other illness that would prevent your participation or use of equipment or machinery except as hereinafter stated. You do hereby acknowledge that you have been informed of the need for a physician’s approval for your participation in an exercise/fitness activity or in the use of exercise equipment and machinery. You also acknowledge that it has been recommended that you have a yearly or more frequent physical examination and consultation with your physician as to physical activity, exercise, and use of exercise and training equipment so that you might have his recommendations concerning these fitness activities and equipment use.


You acknowledge either that you have had a physical examination and have been given your physician’s permission to participate, or that you have decided to participate in activity and use of equipment and machinery without the approval of your physician and do hereby assume all responsibility for your participation and activities, and utilization of equipment and machinery in your activities.


YOU HAVE READ THE FOREGOING, ACKNOWLEDGE THAT YOU UNDERSTAND THE TERMS AND CONDITIONS SET FORTH IN THE PRECEDING PARAGRAPHS, AND AGREE TO SAME.

Express Assumption of All Risks

You have represented to us and acknowledged that you understand and appreciate all of the risks associated with your participation in various services and programs offered by the Club, including the risks of injury, disability, and death. You have also acknowledged that there are greater, enhanced, and even other risks to you if you decide to use a club’s facility during nonsupervised times. Knowing and appreciating all of these risks and enhanced risks, you have knowingly and intelligently determined to expressly assume all risks associated with all of your activities and use of equipment/facilities at a club with the Club’s services or programs.


You understand and are aware that strength, flexibility and aerobic exercise, including the use of equipment, is a potentially hazardous activity. You also understand that fitness activities involve the risk of injury and even death, and that you are voluntarily participating in these activities and using equipment and machinery with knowledge of the dangers involved. We have also reviewed the risks with you on the date when you signed this Agreement and answered any questions that you may have had. You hereby agree to expressly assume and accept any and all risks of injury or death including those related to your use of or presence at this facility, your use of equipment, and your participation in activity, including those risks related to the ordinary negligence of those released by this Agreement and including all claims related to ordinary negligence in the selection, purchase, setup, maintenance, instruction as to use, and use and/or supervision of use, if any, associated with all equipment and facilities.

YOU HAVE READ THE FOREGOING, ACKNOWLEDGE THAT YOU UNDERSTAND THE TERMS AND CONDITIONS SET FORTH IN THE PRECEDING PARAGRAPHS, AND AGREE TO SAME.

Agreement and Release of Liability

In consideration of being allowed to participate in the activities and programs of the Club in addition to the payment of any fee or charge, you do hereby waive, release, and forever discharge the Club and its directors, officers, agents, employees, representatives, successors and assigns, administrators, executors, and all others from any and all responsibilities or liability from injuries or damages resulting from your participation in any activities or your use of equipment/facilities or machinery in the above-mentioned activities. You do also hereby release all of those mentioned and any others acting upon their behalf from any responsibility or liability for any injury or damage to yourself, including those caused by the negligent act or omission of any of those mentioned or others acting on their behalf or in any way arising out of or connected with your participation in any activities of the Club. This provision shall apply to ordinary acts of negligence but shall not apply to gross acts/omissions of negligence, willful or wanton acts/omissions, or those of an intentional/criminal nature.


YOU HAVE READ THE FOREGOING, ACKNOWLEDGE THAT YOU UNDERSTAND THE TERMS AND CONDITIONS SET FORTH IN THE PRECEDING PARAGRAPHS, AND AGREE TO SAME.

User shall receive a copy of the foregoing Agreement at the time of its initialing and signing and hereby acknowledges User’s receipt of same.

YOU HAVE READ THE FOREGOING, ACKNOWLEDGE THAT YOU UNDERSTAND THE TERMS ANDCONDITIONS SET FORTH IN THE PRECEDING PARAGRAPHS, AND AGREE TO SAME.

This Agreement shall be interpreted according to the laws of the Basque Government. If any part of this Agreement should ever be determined by a court of final jurisdiction to be invalid, the remaining portions hereof shall be deemed to be valid and enforceable.

YOU HAVE READ THE FOREGOING, ACKNOWLEDGE THAT YOU UNDERSTAND THE TERMS AND CONDITIONS SET FORTH IN THE PRECEDING PARAGRAPHS, AND AGREE TO SAME.

Acknowledgment

I have read and received a completed copy of this Agreement and all of its Exhibits, as well as any Rules and Regulations of the Club which are incorporated herein by reference. I agree to be bound by the terms and conditions of the Agreement and the Rules and Regulations of the Club, as same exist or as same may be amended from time to time hereafter. This Agreement shall be binding upon me and my spouse, my heirs, my estate, my executors, my administrators, and my successors and/or assigns. I realize that this Agreement is designed to prevent me and/or them from filing any personal injury or other lawsuit based upon ordinary negligence, including negligent battery, or even negligent wrongful death, loss of consortium, or any other similar lawsuit arising out of any injury to me which I or they may possess hereafter. The undersigned, on behalf of myself and my heirs, executors, administrators, successors, and assigns hereby agree to indemnify the Club and all those hereby released and to hold them absolutely harmless if anyone, including the undersigned, should hereafter file suit against the Club or those released hereby for any matter intended to be released by this Agreement, including claims based upon ordinary negligence such as but not limited to personal injury, wrongful death, loss of consortium, or other similar actions.

Cancelation Policy

Terms and Conditions

 

  1. Personal training sessions that are not rescheduled or canceled 24 hours in advance will result in forfeiture of the session and a loss of the financial investment.

  2. Each client will have one free “no show” per package of 12 sessions or greater.

  3. In case of cancelation or rescheduling please write or call me at 622-14-98-48

  4. In case the personal trainer needs to cancel or reschedule a personal training session it will be done at least 24 hours in advance. If the personal training session is not canceled before the 24-hour period prior to the session, then the client will be credited an additional session which must be redeemed within a 7-day period from the cancellation date. 

  5. If the personal trainer cancels a session with more than 24-hour notice, I will not be granted a free session. This session will be rescheduled within 7 days of the original cancellation to ensure consistency with my fitness program.

  6. Clients arriving late will receive only the remaining scheduled session time, sessions will not be extended, and no refund will be given for the time difference.

  7. If the client is more than 20 minutes late for their session the session is therefore forfeited, and no refund is given for the missed session.

  8. The expiration policy requires completion of all personal training sessions within 120 days from the date. Personal training sessions are void after this time period and no refund will be given.

  9. Freeze periods exist within a 120-day period if multiple sessions are going to be missed, but the original expiration timeline must still be respected. 

  10. Notice of holidays should be given at least two weeks in advance of the beginning of the holidays. Additionally, it is the client’s responsibility to redeem training sessions prior to taking holidays. 

  11. In case of cancelation of personal training or other services offered a refund of 50% of the remaining sessions.

Photographic Consent and Release Form

I hereby authorize The Smart Fit Life, and those acting in pursuant to its authority to:


  1. Record my likeness and voice on a video, audio, photographic, digital, electronic or any other medium.

  2. Use my name in connection with these recordings.

  3. Use, reproduce, exhibit or distribute in any medium (e.g. print publications, video tapes, CD-ROM, Internet/WWW) these recordings for any purpose that the University, and those acting pursuant to its authority, deem appropriate, including promotional or advertising efforts.


I release The Smart Fit Life and those acting pursuant to its authority from liability for any violation of any personal or proprietary right I may have in connection with such use. I understand that all such recordings, in whatever medium, shall remain the property of the University. I have read and fully understand the terms of this release.


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