I hereby acknowledge that the information I've given above is complete and accurate. I understand all the risks and I accept all the responsibility for any undesired situations during training. I am informed that my information in this form will be kept confidential.
Leia Nicole Fitness/Leia Crowe has informed me that I am the only responsible party both for any and all injuries during the fitness program and incorrect information. If any of my health, lifestyle or personal information/situation that may prevent my training is changed, I guarantee that I will inform Leia Nicole Fitness/Leia Crowe immediately.