Real Fit Sports Services L.L.C.
Abu Dhabi, UAE
+971 50 363 7147
training@realfit.ae

New Client Registration & Questionnaire

This form includes several questions regarding your physical health. Please answer every question as accurately as possible.

Please ask us if you have any questions. Your response will be treated in a confidential manner.

Personal Information

FIRST NAME:

LAST NAME:

PHONE:

EMAIL:

DATE OF BIRTH:

WEIGHT:

HEIGHT:

EMERGENCY CONTACT:

YES NO

Do you have any personal history of heart disease (coronary or atherosclerotic disease)?

Any personal history of diabetes or another metabolic disease (thyroid, renal, liver)?

Any personal history of pulmonarydisease, asthma, interstitial lung disease, or cystic fibrosis?

Have you experienced pain or discomfort in your chest apparently due to blood flowdeficiency?

Any unaccustomed shortness of breath (perhaps during light exercise)?

Have you had any problems with dizziness or fainting?

Do you have difficulty breathing while standing or sudden breathing problems at night?

MEDICAL HISTORY

Are you currently being treated for high blood pressure?

Are you currently being treated for high blood pressure?

MEDICATIONS

Please list the specific medications that you currently take:

Other Health Conditions Or Injuries

Please indicate any other medical conditions or activity restrictions that you may have, or any other information you feel

is critical to understanding your readiness for exercise. It is essential that this information be accurate and honest.

ASSUMPTION OF RISK, WAIVER AND RELEASE OF LIABILITY, AND INDEMNITY AGREEMENT DECLARATIONS:

This Agreement is entered into between REAL FIT personal trainer (“Trainer”) and the undersigned (“Client”). The provision of personal training services by Trainer 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 Trainer or otherwise, including injuries or damages arising out of the negligence of Trainer, whether active or passive, or any of Trainer’s affiliates, employees, agents, representatives, successors, and assigns. Your assumption of risk includes but is not limited to, your use of any exercise equipment (mechanical or otherwise), sports fields, courts, or other areas, locker rooms, sidewalks, parking lots, stairs, pools, whirlpools, saunas, steam rooms, lobby or other general areas of any facilities, or any equipment. You assume the risk of 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 Trainer or otherwise.
RELEASE: You agree on behalf of yourself (and all your personal representatives, heirs, executors, administrators, agents, and assigns) to release and discharge Trainer (and Trainer’s affiliates, related entities, employees, agents, representatives, successors, and assigns) from any and all claims or causes of action (known or unknown) arising out of the negligence of Trainer, whether active or passive, or any of Trainer’s affiliates, employees, agents, representatives, successors, and assigns. This waiver and release of liability include, without limitation, injuries that may occur as a result of (a) your use of any exercise equipment or facilities which may malfunction or break, (b) improper maintenance of any exercise equipment, premises or facilities, (c) negligent instruction or supervision, including personal training, (d) negligent hiring or retention of employees, and/or (e) slipping or tripping and falling while on any portion of premises or while traveling to or from personal training, including injuries resulting from Trainer’s or anyone else’s negligent inspection or maintenance of the facility or premises.
INDEMNIFICATION: By signing this agreement, you hereby agree to indemnify and hold harmless Trainer from any loss, liability, damage, or cost that may incur due to the provision of personal training by Trainer to you.
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 United Arab Emirates and that if any portion thereof is held invalid, it is agreed that the balance shall, not withstanding, continue in full legal force and effect. You acknowledge that Trainer offers a service to his / her clients encompassing the entire recreational and/or fitness spectrum. The trainer is not in the business of selling weightlifting equipment, exercise equipment, or other such products to the public, and the use of such items is incidental to the service provided by Trainer. You acknowledge and agree that Trainer does not place such items into the stream of commerce. This release is not intended as an attempted release of claims of gross negligence or intentional acts. 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 trainer for the trainer’s negligence, or for any defective product used while receiving personal training from the trainer. 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.

CANCELLATION POLICY:

A 12-hour notice is required for a cancellation or rescheduling in order to receive credit for the session. Failure to cancel within this time frame or failure to show up for a session will result in the client being charged for the session. Exceptions will only be made in the case of a medical emergency accompanied by a doctor’s note. There is a no-refund policy on all packages purchased – a client may only receive a refund if accompanied by a doctor’s note.

TARDINESS POLICY:

Clients are expected to begin working out at the start time of the scheduled appointment. Clients starting late will receive the remaining scheduled session time unless other arrangements have been previously made with the trainer.

EXPIRATION DATES ON PACKAGES:

The expiration policy requires the completion of all personal training sessions within (depending on the package) from the first session conducted. Any sessions that remain after the expiration date will be forfeited.

Package of 10 trainings – 45 days

Package of 20 trainings – 90 days

Package of 30 trainings – 135 days

I understand that REAL FIT TRAINERS operates on a scheduled hourly appointment basis for private training sessions, therefore I verify that I understand and will abide by these policies.

I have carefully read and understood the above information. The policies have been explained to me and any questions have been answered to my satisfaction.

Name:

Signature:

Clear Signature

Date: