Consent Form

I, (your name) , acknowledge that I have chosen to participate in a workout program of physical exercise provided by Roc Fitness Training. I understand that such a program will enhance the musculoskeletal and cardio respiratory systems. I also understand that there are inherent risks in participating in a program of strenuous exercise. I have been informed of the possible strenuous nature of a personal training program and the potential for unusual, but possible, physiological results including, but not limited to, abnormal blood pressure, muscle soreness, fainting, heart attack or death.

I have read and I understand this term: (initial here)

I understand that I am not obligated to perform nor participate in any activity that I do not wish to do, and that it is my right to refuse such participation at any time during my training sessions. I understand that should I feel lightheaded, faint, dizzy, nauseated or experience pain or discomfort, I am to stop the activity and inform my Personal Trainer. I give Roc Fitness Training and its Personal Trainer permission to seek emergency medical services for me should I become injured or ill with the understanding that I am responsible for any expenses incurred.

I have read and I understand this term: (initial here)

I guarantee that the answers to the questions outlined on the Medical History (PAR-Q) form are true and complete to the best of my knowledge. I understand medical clearance may be required based on the answers I gave on the Medical History (PAR-Q) form. I understand and agree that it is my responsibility to inform my Personal Trainer of any conditions or changes in my health, now and ongoing, which might affect my ability to exercise safely and with minimal risk of injury.

I have read and I understand this term: (initial here)

By signing this document, I assume all risk for my health and well being and hold harmless of any responsibility, Roc Fitness Training or the Personal Trainer with this exercise program(s). I understand that questions about exercise procedures and recommendations are encouraged and welcome.

I have read, understood and completed this questionnaire. Any questions I had were answered to my full satisfaction.

Client's Signature:

Today’s Date (mm/dd/yy):

(By entering your name, you agree to accept the terms of the above document with an electronic signature.)