Informed Consent Agreement

INFORMED CONSENT AGREEMENT

Description of the Exercise Program: I understand that the exercise program will involve participation in a number of types of fitness activities, including but not limited to:

1. Pilates exercises,
2. aerobic activities,
3. stretching exercises,
4. muscular endurance and strength building exercises,
5. other activities selected by my trainer/instructor,
6. If completing a Initial Assessment – Selected physical fitness and body composition tests.

Description of Potential Risks: I understand that no exercise program is without inherent risks and that, regardless of the care taken by my instructor, he (or she) cannot guarantee my personal safety. I realize that when participating in any exercises or conditioning activity, there is always a possibility that injury may occur.

Client Responsibilities: I understand that it is my responsibility to: 1) fully disclose any health/ medical  conditions; 2) inform the trainer if there are activities with which I do not feel comfortable; 3) cease exercise and report promptly any unusual feelings (e.g., chest discomfort, nausea, dizziness breathing, apparent injury) during the exercise program; & 4) clear my participation with my physician.

Client Acknowledgements: In agreeing to this exercise program, I, the client:

1. Acknowledge that my participation is completely voluntary;
2. Understand the potential physical risks involved in the exercise program and believe that the potential benefits outweigh those risks;
3. Give consent to certain physical touching that may be necessary to ensure proper technique and body alignment;
4. Ask questions regarding any concerns I might have, and have had those questions answered to my satisfaction &
5. Will cease exercise immediately if I experience unusual discomfort or pain.

I have read and understand the above informed consent information. I acknowledge that I am signing the informed consent agreement freely and voluntarily. My signature is intended acknowledge my comprehension of my client responsibilities and acknowledgements and to verify a complete assumption of the inherent risks associated with the training program offered by Living Energy Pilates & Rehabilitation.