FollowMeFit Training Registration Form

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This form must be filled out by everyone wishing to participate in any followmefit activities (including the free, no-obligation, trial class for all new boot campers). This form is used for all Live/In-Person training: one on one training, partner training, group training, and boot camps; as well as remote or online training such as, but not limited to: @Home / GOfit▶ Boot Camp, Online Fitness Classes, Private FaceBook Group or YouTube Videos, challenges, written or app assigned remote programs for individuals, partners, or groups.

Email *

Confirm Email

Email is required for receiving camp, class, & training updates

For which FollowMeFit Service are you Registering? *

Check all that apply

5:30am - MW - Live Boot Camp

7:30am - MW - Live Boot Camp

8:30am - MW - Live Basic30 Camp

GOfit▶ At-Home Workout Videos (GymShorts app-led workouts included)

GOfit▶ Plus (At-Home Workout Videos plus GymStrong full length app-leg workouts)

Other:

Required

General Personal Information

Full Name *

First Last

Date of Birth *

YYYY

Age

Street Address *

City, State Zip *

Phone Number *

(for receiving text updates from trainer)

Emergency Contact

Emergency Number *

(555) 555-5555

Emergency Name & Relation *

(spouse, neighbor, co-worker, friend, mom, etc)

Physical Activity Readiness Questionnaire

It is recommended that everyone consult their physician before engaging in physical activity, but If you check one or more of the boxes in the next two sections, please be aware that you may be at a HIGH or INCREASED RISK during exercise. If this is you, consult your physician before engaging in physical activity. Tell your physician which statements apply to you. After medical evaluation, seek advice from your physician on what type of activity is suitable for your current condition and if he or she recommends any limitations. Please inform trainer in writing of any medical limitations, restrictions, or concerns. Medical Clearance forms are available at tiny.cc/FMFmed or upon request from your trainer.

Check all the HIGH RISK health issues that apply to you: *

Your doctor has said that you have a heart condition and that you should only perform physical activities recommended by a doctor.

You feel pain in your chest when you perform physical activity.

In the past month, you have had chest pain when you were not performing any physical activity.

You lose your balance because of dizziness or you have previously lost consciousness (fainting or blackouts).

Your doctor is currently prescribing medication for your blood pressure or for a heart condition.

You have a history of heart problems, chest pain or stroke.

You have diabetes.

You have asthma or other lung disease.

You have burning or cramping sensation in your lower legs when walking short distances.

You are pregnant or think you may be pregnant.

You know of any other reasons why you might be considered a high risk and should not engage in physical activity.

N/A -- none applicable

Other:

Required

Check all the INCREASED RISK health issues that apply: *

You are physically inactive.

You are 20+ pounds overweight.

You smoke, or quit smoking within the previous 6 months.

Your blood pressure is > than 140/90 mmHg or you are currently taking blood pressure medication.

Your blood cholesterol level is > 200 mg/dL.

You have a close blood relative (sibling/parent) who had a heart attack/surgery before age 55-male or age 65-female.

Your fasting blood glucose has been measured at or greater than 100 mg/dl on at least two separate occasions.

You are currently on prescription medications that may affect exercise (balance, energy level, heart rate, etc).

You have a bone or joint problem that could be made worse by a change in your physical activity.

You have concerns about the safety of exercise or know of other reasons you would be considered an increased risk during exercise.

N/A -- none applicable

Other:

Required

Prescription Meds

List any prescription medications that may affect exercise (balance, energy level, heart rate, etc).

Injuries:

Please list any injuries that may affect exercise (past and present) and give pertinent details (Shoulder, Hip, Knee, Low Back, other:)

Explain Health Issues

Please explain any health issues that were checked above.

Help Me Get to Know You

Tell me something about yourself. Who are you? How did you find me?
What are your concerns and goals?
Is there anything else you think your trainer should know about you?

Master Service Agreement

This document will govern all transactions for personal-training services with Follow Me Fit.
I agree to the follow terms:

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Personal Training Sessions and Payment

I will make advanced nonrefundable payments for each individual or group session in advance. I understand that all sessions expire within six months from purchase.

I will give at least 24 hours notice for a cancellation. Cancellations without proper notice will result in the loss of that session without a refund.

If I cancel more than one session within a two month period, Follow Me Fit may give my time slot to another client and my services may be put on hold until another time slot is available.

I will provide notice by phone, voicemail, or text message if I will be late to a session. If, for any reason, I am more than ten minutes late without providing notice, I will forfeit the session without a refund.

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Small Group Session / Boot Camp / GOfit▶ Online Training & Programming / Challenges and Payments

I will make advanced nonrefundable payments for the entirety of any Fit/Boot Camp, month of Small Group Session, GOfit▶ Online Training Package & Programming, or Challenges of which I wish to participate. I will use these services within their specified dates and times or I will forfeit the purchased sessions without a refund.

I understand that payments for Fit/Boot Camp, month of Small Group Session, GOfit▶ Online Training & Programming, or Challenges secure my slot for that time period of that specific camp or month and do not carry over to other camps, months, or services if not used.

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Liability Release and Assumption of Risk

I hereby release Follow Me Fit and Shelley Scott from all liability for any injury, illness, or death related to equipment, advice, training, or any service provided by Follow Me Fit or Shelley Scott, including liability from negligent or reckless actions.

I acknowledge that exercise is a potentially dangerous activity, even under the supervision of a trained exercise professional, and I expressly assume all risk of injury, illness, and death that may result from fitness activities. If I am engaged in online training with Follow Me Fit and Shelley Scott, I acknowledge that I am not being monitored by any trainer and that there is no liability to the trainer if an injury is sustained. If I am unable to complete any exercise due to physical limitation or lack of understanding I WILL NOT attempt. If I do attempt, I will be liable for any injury sustained.

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Medical Declarations

I am physically sound and suffering from no condition that would prevent my participation in fitness activity.

I will inform my trainer of any symptoms, including fatigue, shortness of breath, chest discomfort, or joint pain. I acknowledge that I have the right to decrease or stop fitness activity at any time during the course of a session.

I have been informed of the need for a physician’s approval to participate in fitness activity. I have either received permission from a physician, after an examination, to participate in fitness activity or decided to participate in fitness activity without the approval of a physician.

I consent to the provision of emergency care and CPR.

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Disclaimer of Warranty

Follow Me Fit and Shelley Scott hereby expressly disclaim all warranties, express or implied, as to the quality, character, or results of the services provided under this agreement.

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Miscellaneous Provisions

I will not assign training services, or any other rights or interests under this contract, to any other person without express written consent from Follow Me Fit. If any portion of this contract is held unenforceable, all other portions of the contract will remain in full force and effect. Any litigation arising in connection to this agreement will be resolved in the trial courts of Montgomery County, Tennessee, which is the location of the contract’s execution and performance

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Entire Agreement

This document is the entire agreement between the parties for the terms contained herein. It supersedes all prior negotiations, agreements, and understandings. Where subsequent agreements conflict with this document, this document controls unless it is expressly overridden in writing and signed by both parties.

I Agree *

I have read and agree to the terms and conditions outlined above in the Master Service Agreement.

Signature *

By entering my name below, I am effectively providing my signature, indicating that all the information on this form is true and accurate, to the best of my knowledge and that I have read and am in full agreement to the terms outlined in the above Master Service Agreement, Representation, Agreement, Release/Waiver of Liability and Indemnity Agreement.

Date *

YYYY

Send me a copy of my responses.

Submit

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