Clone of Clone of New Member Registration Form

Name

First NameMiddle NameLast Name

E-mail

Sex

Date of Birth

MonthDayYear

Height (inches)

Weight (pounds)

Contact Number:

Area CodePhone Number

Address:

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry

In case of emergency...

Emergency Contact:

First NameLast Name

Relationship

Contact Number

Area CodePhone Number

Taking any medications, currently?

YesNo

If yes, please list it here

Client Questionnaire: Common sense is your best guide when you answer this questionnaire. Please read the questions carefully and answer each one honestly.

Has your doctor ever said that you have a heart condition and that you should only do physical activity recommended by a doctor?

YESNO

Do you feel pain in your chest when you do physical activity?

YESNO

In the past month, have you had chest pain when you were not doing physicalactivity?

YESNO

Do you lose balance because of dizziness or do you ever lose consciousness?

YESNO

Do you have bone or joint problem (for example, back, knee, or hip) that could be worsened by a change in your physical activity?

YESNO

Has your doctor currently prescribed drugs (for example water pills) for your blood pressure or heart condition?

YESNO

Do you know of any other reason why you should not do physical activity?

YESNO

If you answered "YES" to any of the above, please explain below.

Liability Waiver:

I am aware of the risks in observing or participating in the activities offered and sponsored by TaylorMade Fitness and I understand that in all sports and/or fitness that I will execute and participate in are entirely at my own risk and perils. I assume complete responsibility and liability for those risks and for the injuries that may occur as a result of these risks, even if injuries occur in a manner that is not foreseeable at the time I sign this agreement. I realize that by voluntarily assuming the risks involved, I will be solely responsible for any loss or damage I sustain, including personal injuries to me, damage to my property, or damage arising out of my death. It is understood that TaylorMade Fitness is responsible for any damage that would be resulting from a fault of TaylorMade Fitness and its representatives.

Type Name to Acknowledge Liability Waiver

Cancellation Policy:

All cancellations must be received at least 24h before your training session in order to avoid being charged. Clients who do not cancel with 24h notice will be charged 50% of a regular price session for the cancellation.

TaylorMade Fitness understands that emergencies happen. We provide every client with one free short-notice cancellation. You will not be charged for your first cancellation with less than 24h notice. Subsequent short notice cancellations will be charged for the session. The free short-notice cancellation only applies if TaylorMade Fitness or your trainer is notified prior to the session start time. No shows are not eligible for the free cancellation.

Type Name to Acknowledge Cancellation Policy

Select the package that will best suit your fitness goals.

Pick Your Desired Training*

Plan A (unlimited group sessions) $ 125 MonthlyPlan B: Unlimited Group Sessions @ 5:30PM and 5 Individual Session $175.00 MonthlyUnlimited Group Sessions/Unlimited Individual Sessions $200.00 MonthlyIndividual Sessions $25.00 Per SessionGroup Sessions $15.00 Per SessionSkill and Agility Training (Youth) $25.00 Per SessionSkill and Agility Training-3 Sessions Per Week $225 MonthlyMobile Training Session- Single Session $50.00Mobile Training Session- Group of 2 or More- 3x Week $150.00 Weekly

Signature*