FIT LIFE MOVEMENT ONBOARDING QUESTIONNAIRE
Address Line 2
State / Province / Region
ZIP / Postal Code
Antigua and Barbuda
Bonaire, Sint Eustatius and Saba
Bosnia and Herzegovina
British Indian Ocean Territory
Central African Republic
Congo, Democratic Republic of the
French Southern Territories
Heard Island and McDonald Islands
Isle of Man
Korea, Democratic People's Republic of
Korea, Republic of
Lao People's Democratic Republic
Northern Mariana Islands
Palestine, State of
Papua New Guinea
Saint Helena, Ascension and Tristan da Cunha
Saint Kitts and Nevis
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Sao Tome and Principe
South Georgia and the South Sandwich Islands
Svalbard and Jan Mayen
Syria Arab Republic
Tanzania, the United Republic of
Trinidad and Tobago
Turks and Caicos Islands
US Minor Outlying Islands
United Arab Emirates
Virgin Islands, British
Virgin Islands, U.S.
Wallis and Futuna
MM slash DD slash YYYY
Weight in lbs
How comfortable are you in the gym?
Not at all
What have you tried in the past?
6 month goals
12 month goals
Beginner (M) (2)
Beginner (F) (2)
Men under 151lbs
Men 151 – 180
Men 181 – 220lbs
Men over 221lbs
Women under 131lbs
Women 131 – 160
Women 161 – 190lbs
Women over 190lbs
ASSUMPTION OF RISK, WAIVER AND RELEASE OF LIABILITY, AND INDEMNITY AGREEMENT
DECLARATIONS: This Agreement is entered into between L8R LIFESTYLE, LLC (“Coach”) and the undersigned (“Client”). The provision of personal training services by Coach and Coach’s affiliates, related entities, employees, agents, representatives, successors, and assigns (collectively, the Coach Parties) to Client, and Client’s use of any premises, facilities or equipment are contingent upon this Agreement.
ASSUMPTION OF RISK: You agree that if you engage in any physical exercise or activity, including personal training, or enter our premises or use any facility or equipment on our premises for any purpose, you do so at your own risk and assume the risk of any and all injury and/or damage you may suffer, whether while engaging in physical exercise or not. This includes injury or damage sustained while and/or resulting from using any premises or facility, or using any equipment, whether provided to you by the Coach Parties or otherwise, including injuries or damages arising out of the negligence of Coach or any of the Coach Parties, whether active or passive. Your assumption of risk includes, but is not limited to, your participation in any activity, class, program, instruction, or event, including but not limited to weightlifting, walking, jogging, running, aerobic activities, aquatic activities, tennis, basketball, volleyball, racquetball, or any other sporting or recreational endeavor. You agree that you are voluntarily participating in the aforementioned activities and assume all risk of injury, illness, damage, or loss to you or your property that might result, including, without limitation, any loss or theft of any personal property, whether arising out of the negligence of Coach or any of the Coach Parties or otherwise.
RELEASE: You agree on behalf of yourself (and all your personal representatives, heirs, executors, administrators, agents, and assigns) to release and discharge Coach and the Coach Parties from any and all claims or causes of action (known or unknown) arising from your participation in the services provided by Coach. This waiver and release of liability includes, without limitation, injuries which may occur as a result of (a) your use of any exercise equipment or facilities which may malfunction or break, (b) negligent instruction or supervision, including personal training, (c) negligent hiring or retention of employees.
INDEMNIFICATION: By execution of this agreement, you hereby agree to indemnify and hold harmless Coach and each of the Coach Parties from any loss, liability, damage, or cost Coach or any of the Coach Parties may incur due to the provision of personal training by Coach the Coach Parties to you or that arise from your breach of any agreement, or policy governing the services provided to you by the Coach Parties.
ACKNOWLEDGMENTS: You expressly agree that the foregoing release, waiver, assumption of risk and indemnity agreement is intended to be as broad and inclusive as permitted by the law in the State of Utah and that if any portion thereof is held invalid, it is agreed that the balance shall, notwithstanding, continue in full legal force and effect. You acknowledge that Coach the Coach Parties offers a service to his/her clients encompassing the entire nutritional and/or fitness spectrum. This release is not intended as an attempted release of claims of gross negligence or intentional acts.
LIMITATION OF LIABILITY. NOTWITHSTANDING ANYTHING HEREIN TO THE CONTRARY, NEITHER PARTY SHALL BE LIABLE TO THE OTHER PARTY FOR SPECIAL, INDIRECT, CONSEQUENTIAL, PUNITIVE OR EXEMPLARY DAMAGES SUFFERED BY SUCH PARTY RESULTING FROM OR ARISING OUT OF THIS WAIVER AND RELEASE, INCLUDING WITHOUT LIMITATION, SERVICES PROVIDED AS CONTEMPLATED HEREBY, OR UNDER ANY OTHER THEORY OF LIABILITY, WHETHER TORT, NEGLIGENCE, STRICT LIABILITY, BREACH OF CONTRACT, WARRANTY, INDEMNITY OR OTHERWISE, INCLUDING LOSS OF USE, INCREASED COST OF OPERATIONS, LOSS OF PROFIT OR REVENUE, OR BUSINESS INTERRUPTIONS. ADDITIONALLY, IN NO EVENT SHALL THE LIABILITY OF EITHER PARTY EXCEED THE TOTAL AMOUNT PAID BY YOU TO THE COACH OR ANY OF THE COACH PARTIES FOR THE SERVICES RENDERED TO YOU BY THE COACH OR ANY OF THE COACH PARTIES DURING THE TWELVE MONTH PERIOD LEADING UP TO THE EVENT OR EVENTS GIVING RISE TO SUCH CLAIM.
LICENSE TO USE PHOTOGRAPHS: From time-to-time, client will provide information, or videos, or pictures to Coach or the Coach Parties to track progress and accurately update your program. For any content that is covered by intellectual property rights, you specifically give Coach and the Coach Parties a non-exclusive, transferable, sub- licensable, royalty-free, worldwide license to use any intellectual property content that you provide to Coach or any of the Coach Parties.
You agree that you will only provide the Coach Parties with information, pictures, videos or other intellectual property that you own. Coach acknowledges that this license does not transfer any ownership – You will continue to own my information, pictures, videos and other intellectual property.
This license only permits the Coach Parties to use these items for 2 purposes; 1. to improve my program, 2. for their own purposes of self- promotion, including advertising their business, in any manner and medium, such as publicity, illustration, advertising, and web content. The Coach will get my consent before using my photos for any reason listed under purpose 2. Coach may alter and composite these items without restriction and without my inspection or approval. You hereby release the Coach parties and their associates from all claims and liability relating to any materials you provide to them.
GOVERNING LAW; VENUE: The parties expressly agree that this waiver and release shall be governed solely by the laws of the State of Utah, without regard to its principles of conflict of laws. You hereby expressly consent to the personal jurisdiction of the state and federal courts located in or about Salt Lake City, Utah for any action or proceeding arising from or relating to this waiver and release, waives any argument that venue in any such forum is not convenient, and agrees that any such action or proceeding shall only be venued in such courts.
PRIVACY: You understand that Coach is committed to preserving my privacy, but that the Coach Parties may need to disclose my personal information when required by law. The Coach Parties will not sell my name or other private information to third parties. The Coach Parties will only share my information with its partners to provide the product, service, or specific promotional materials you request and will only use your information as permitted by the intellectual property license provided by you above.
DECLARATION: You acknowledge that you have carefully read this waiver and release and fully understand that it is a release of liability, express assumption of risk and indemnity agreement. You are aware and agree that by executing this waiver and release, you are giving up your right to bring a legal action or assert a claim against the Coach Parties for their negligence, or for any defective product used while receiving personal training from any of the Coach Parties. You have read and voluntarily signed the waiver and release and further agree that no oral representations, statements, or inducement apart from the foregoing written agreement have been made.
Draw your signature inside the box.