Class Registration Form
Please fill out form so I can get to know you more. All information shall remain strictly confidential*
Today's Date *
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How did you hear about Intensity Fitness Classes *
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First and Last Name *
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Address *
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City/State/Zip *
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Phone *
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Email *
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Emergency Contact Name *
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Emergency Contact Phone # *
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Best way to notify you in the event scheduled workout class is cancelled for that day ? *
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Current Age
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Birth Date
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Primary Fitness Goals (Can choose more than one) *
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Fitness Level *
Please list any health/medical issues or concerns: *
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Waiver, Agreement and Release Form Intensity Fitness Class - Waiver Of Liability: I, the undersigned have enrolled in a fitness/exercise program of strenuous physical activity which may include but is not limited to aerobic conditioning and cardiovascular conditioning, weight training, strength training and flexibility training offered by Intensity Fitness and their staff. In consideration of my participation in this fitness/exercise program, the undersigned, for myself, my heirs and assigns, hereby release Intensity Fitness(it’s owner, employees facility, organization, business or any persons involved with the fitness/exercise program), from any claims, demands and causes of action arising from my participation in the fitness/exercise program. I fully understand that I may injure myself as a result of my participation in the fitness/exercise program and I do hereby release Intensity Fitness (it’s employees and owner), from any liability now or in the future including but not limited to heart attacks, muscle strains, pulls or tears, broken bones, shin splints, heat prostration, knee/back/foot injuries and any other illness, soreness or injury caused, occurring, during or after my participation in the fitness/exercise program. I hereby affirm with my signature below that I have read, understand and agree to the above. Intensity Fitness Class - Physicians Examination Waiver: ATTENTION: You should consult with your physician before beginning exercise classes or any type of workout program. Factors unknown to you may have an adverse affect on your physical well-being, including death. You should inform your physician that you are about to begin a fitness program. By signing this document, I the undersigned acknowledge that I am aware of the potential risks that could occur and that I should consult with and obtain a physician's approval prior to beginning a fitness/exercise program. If I choose to not get a physician’s approval, I fully accept all responsibility for my health and any resultant injury or mishap that may affect my well being or health in any way. I fully understand that the fitness/exercise program may be strenuous and I choose to participate completely voluntarily. I fully accept all responsibility for my health and any resultant injury or mishap that may affect my well being or health in any way. I hold harmless of any responsibility, the trainer/instructor, facility, organization, business or any persons involved with the fitness/exercise program. I hereby affirm with my signature below that I have read, understand and agree to the above. Intensity Fitness Class - Policy/Procedure Agreement: I the undersigned, agree to the policies and procedures that have been presented to me. Failure to comply with the policies and procedures at any given time can result in termination of my service participation. I further understand that no refunds for unused classes will be given unless a documented medical release is provided, stating a severe illness or condition, which limits me from continuing the program. I also understand that I must give at least 24 hours advanced notice if unable to attend a scheduled class session, and that canceling with less than 24 hour’s notice can result in a session being deducted from my remaining sessions balance. If I am deemed a No Call - No Show for a scheduled class, a session will be deducted from my account. I hereby affirm with my signature below that I have read, understand and agree to the above. Intensity Fitness Class - Model Release: I, the undersigned do hereby give to Sid Karim (the Photographer), his assigns, licensees, successors in interest, legal representatives, and heirs the irrevocable right to use my name (or any fictional name), picture, portrait, image or photograph in all forms and in all media and in all manners, without any restriction as to changes or alterations (including but not limited to composite or distorted representations or derivative works made in any medium) for advertising, trade, promotion, exhibition, or any other lawful purposes, and I waive any right to inspect or approve the photograph(s) and/or videos finished version(s) incorporating the photograph(s) and/or videos, including written copy that may be created and appear in connection therewith. I hereby release and agree to hold harmless the Photographer, his or her assigns, licensees, successors in interest, legal representatives and heirs from any liability by virtue of any blurring, distortion, alteration, optical illusion, or use in composite form whether intentional or otherwise, that may occur or be produced in the taking of the photographs, or in any processing tending toward the completion of the finished product, unless it can be shown that they and the publication thereof were maliciously caused, produced, and published solely for the purpose of subjecting me to conspicuous ridicule, scandal, reproach, scorn, and indignity. I agree that the Photographer owns the copyright in these photographs and/or videos or works and I hereby waive any claims I may have based on any usage of the photographs and/or videos or works derived there from, including but not limited to claims for either invasion of privacy or libel. I am of full age and competent to sign this release. I agree that this release shall be binding on me, my legal representatives, heirs, and assigns. I have read this release and am fully familiar with its contents. I hereby affirm with my signature below that I have read, understand and agree to all of the above in its complete entirety! *
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