Fitness Training Studios

Medical History

If you are returning and have no medical changes, the medical section below does not need to be completed. All agreements remain the same.

NOTICE: It is wise to seek your doctor’s advice before beginning any health/fitness/nutrition program!

Applicant Information

Email Address:

1. Are you allergic to any medication (aspirin, penicillin, sulfa, etc.)?

2. Do you take any prescribed medication on a permanent or semi-permanent basis?

3. Do you wear glasses or contact lenses?
Yes No

4. Do you have or have you ever had the following:

Diabetes, adult or juvenile? Yes No
Asthma? Yes No
Anemia? Yes No
High blood pressure (hypertension)? Yes No
Seizure disorder (epilepsy)? Yes No
Heart disease? Yes No
Lung disease? Yes No
Kidney disease? Yes No
Liver disease? Yes No

5. Have you ever been knocked out? Describe:

6. Have you had a broken bone or fracture in the past 2 years? Describe:

7. Have you ever had a severe neck injury? Describe:

8. Have you ever injured your back? Describe:

9. Do you have back pain?

10. Have you had knee pain in the past 2 years that has disabled you for longer than a week? Describe:

12. Detail any surgical procedures:

Release

Training Studios is to provide fitness instruction and coaching for various levels of athletes/individuals. The undersigned hereby acknowledge that the following was explained to me and/or agree to the following:

1. Acknowledges that Avery Williamson and Fitness Training Studios Coaches and Personal Trainers are not physicians and are not trained in any way to provide medical diagnosis, medical treatment, or any other type of medical advice.

2. Acknowledges that coaching/training is another tool for teaching athletes/individuals about themselves, but that Fitness Training Studio does not guarantee neither good nor bad will occur nor guarantees the training advice given by Fitness Training Studios will produce good nor bad results.

3. Acknowledges that the undersigned has been told if they feel tired, feel pain or feel out of the ordinary in any way either related to your training, or otherwise, that the undersigned should contact a physician at once.

4. Acknowledges that boot camps, aerobic classes, martial arts, kick boxing, running, kung-fu, weight training, obstacle courses, and any other related sports are an extreme test of one's mental and physical limits and carry with it potential for damage or loss of property, serious injury and death. That the undersigned assumes the risks of participating in these types of events/activities including the inherent dangers of the natural elements, that they are fit, and they have a regular medical physician they can contact regarding any medical problems that they might develop. The undersigned expressly waive, release, discharge and agree not to sue from any liability of death, disability, personal injury, or action of any kind and Austin Adventure Boot Camp for the undersigned participating in said sporting events and/or training for said sporting events.

The Undersigned agrees that this is the full agreement between the parties, that Fitness Training Studios, nor anyone else has not verbally contradicted any of the terms of this release and that the undersigned has entered into this agreement free and voluntarily without force or coercion.

Check the following:

	I will remember to be at camp on time.
	I agree that I will not consume alcohol during the month of Boot Camp. Any violation will result in twenty push-ups per occurrence.
	I agree not to use foul language during Boot Camp. Any violation will result in twenty push-ups per occurrence.
	I agree not to eat or say the words Donuts, Chocolate, Cookies, or Cup Cake during the course of Boot Camp. Any violation will result in twenty push-ups per occurrence.
	I agree to show up for Boot Camp every day unless it is an excused absence from my doctor or pre-approved with Boot Camp directors. Any violation will result in twenty push-ups per occurrence.
	I understand that photos or video may be taken during the course of my involvement in Boot Camp, which may be used for promotional purposes. I understand that my "before & after" photos will not be used for any promotional purposes unless I give written authorization.
	I understand there is no refund policy. If I am not able to complete the camp I originally started due to injury or major illness that keeps me from attending camp for 4 or more consecutive days, then at Fitness Training Studios discretion I may receive a credit towards the purchase of the next immediate boot camp (my credit days + my purchased days must equal a full camp session). Credits will be applied only to the session starting immediately following the session in which the days were missed. My request for credit consideration must be received before the end of this current camp session. I understand that this credit is nontransferable, there is no cash refund, and this is not negotiable.

Your signature will be required at the time of your enrollment, and you agree to the terms now!