May 2024+ Service Customization

Prospect Outcome

Not Signing UpSigning Up

Client Name

Trainer Name

Reason for Declining Service

Choose Your Goal

Muscle Shape, Strength, & Stamina - You Need a Personal TrainerWeight Loss &/or Healthy Function - You Need a Registered DietitianBoth Fat Loss & Muscle Development - You Need BOTH Trainer & Dietitian

Personal Training Frequency

Platinum - (4 customized sessions per week)Gold - (3 customized sessions per week)Silver - (2 customized sessions per week)Bronze - (1 customized session per week)

Body-Changing Nutrition

Weekly VideoChats (or Phone Calls) and Daily Diet Accountability and Advising with our Licensed and Registered Dietitian

Participation

IndividualShared

*Nutrition only programs (i.e. when not combined with training) are all individual, & therefore are not discounted when shared.

Final Monthly Investment

Were you able to start your Jumpstart within 7 days?

NoYes

Service to Start on:

MonthDayYear

Service to End or Renew on:

MonthDayYear

Service Schedule & Missed Session Policy:*

Any sessions NOT redeemed within this time period WILL BE FORFEITED. If at any time, I need to cancel a scheduled session, I must provide at least 24 HOURS ADVANCED NOTICE to my trainer, OR FORFEIT THE SESSION. If I must miss a regularly scheduled session, it is imperative that I make EVERY effort to make up the session as soon as possible, reducing the risk of forfeiture. No refunds will be given, NOR CAN THIS AGREEMENT BE EXTENDED. I can, however, upgrade at any time to a higher level of accountability and results.

Company Team Support:*

I also acknowledge that I am entering an agreement with Elect Wellness, not a specific personal trainer or nutrition coach. From time to time, Elect Wellness may choose to assign a personal trainer or nutrition coach to complete my agreement other than the ones that began servicing my agreement. However, in the event that I am not satisfied with my personal trainer or nutrition coach, I have the right to request another.

Agreement Cancellation Terms:*

If, for some reason, I quit on my commitment, I the client agree to pay a cancellation fee of 33% of regular monthly payment. I understand that I will not be refunded any money already paid, and have 30 days from my last scheduled payment to redeem any outstanding sessions.

Understanding Why:*

I fully understand that these terms & conditions are instituted so that Elect Wellness can continue to offer professional services &, most importantly, I can continue to make progress & achieve my health & fitness goals. If I am not satisfied with Elect Wellness, I can cancel anytime within the first 30 days of this agreement, & receive a full refund.

Convenient Continuation of Agreement:*

For my convenience and the continuation of a healthy lifestyle, working out regularly and eating right, without 30 days notice of cancellation by me, the client, this agreement will auto-renew under the same conditions, and commence again on the aforementioned ending date.

Scope of Service*

Elect Wellness team members are fitness and nutrition professionals providing fitness and nutrition services. I understand that Elect Wellness employees are not educated, trained, licensed, certified, or insured specifically for … and can NOT provide … home help (i.e. assistance with bathing, dressing, grooming, housekeeping, transportation, medication administration, etc.)

Coach Employment Policy*

Elect Wellness makes substantial monetary and time investments in searching, filtering, interviewing, testing, hiring, training, employing, and continually educating each of its team members. In recognition of that investment, I the client agree not to directly or indirectly hire any employee of Elect Wellness for a period of one year from the last date on which the employee worked with me without obtaining written consent of Elect Wellness. If I the client violate this provision, then I shall be liable to Elect Wellness for $15,000 per employee hired in liquidated damages. I the client agree that the damages suffered by Elect Wellness would be difficult to ascertain, and that these amounts are intended to reasonably compensate Elect Wellness for damages that would occur if its employees are hired directly or indirectly by me.

Full Name

First NameLast Name

Today's Month

Today's Day

Today's Year

E-mail (for copy)*

Signature

Payment Perspective:*

I understand that Elect Wellness is extending a 0% interest payment plan option for the service total agreed upon, & in choosing that option, I understand these payments are due on a specific schedule. I further understand that I am receiving a discounted rate for my chosen frequency of coaching & the duration of my commitment. The recurring auto debit is not only for the efficient delivery of my service, but also for my convenience.

I, ____________ authorize Elect Wellness

First NameLast Name

... to charge ________ to my credit card today ...

and ___________

... on the __________ of each month for my health and fitness coaching and consulting services.

Signature

Customize Your Program