Personal Training Contract

Hassan Abbass Personal Training Contract

PHYSICAL ACTIVITY READINESS QUESTIONNAIRE Yes

No

Yes Yes Yes

No No No

Yes

No

Yes Yes

No No

Has a doctor ever said that you have a heart condition and recommended only medically supervised activity? Do you have chest pain brought on by physical activity? Have you developed chest pain in the past month? Have you on one or more occasions lost consciousness or fallen over as a result of dizziness? Do you have a bone or joint problem that could be aggravated by the proposed physical activity? Has a doctor ever recommended medication for your blood pressure or a heart condition? Are you aware, through your own experience, or a doctor’s advice, of any other physical reason that would prohibit you from exercising without medical supervision?

 If you answered answered “yes” to any of these questions, call call your personal personal physician physician or healthcare healthcare provider provider before I ncreasin ncreasin g your physical physical activity level. level.

Last name:

First Name:

MI:

Address: Day Phone:

Campus or Local including City, State, and Zip Code Email:

Check one:

 New Client

Renewal-Name of Trainer:

Session payments are non-refundable. Sessions Sessions are 60 minutes in length starting at your scheduled time. If you are more than 15 minutes late, it will be considered a No Show   and you will be charged. You must call your  and personal trainer with cancellation cancellation at least 12 hours in advance before the session in order to reschedule. One session is good for 3 0 days after the original date of purchase.   Five session packages are good for 45 days after the original date of purchase. Ten session packages are good for 6 0 days after the original date of purchase. 

I state that I have read this document, document, agree agree with its term term s and and am signing th is contract volunt aril y.

Signature:

Date:

FOR OFF OFF I CE USE USE ONLY Packages 1 Sessions

$

5 Sessions

$

75

10 sessions

$

150

30 sessions

Total Due:  $ ______ 

15

 Purchase 30+ sessions and receive receive 10% off total price

Paid By:  Cash  Credit

Card  Check # ______ Initials: ______