ENROLLMENT FORM

For WhatsApp/text communication, if it’s included in your plan.

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

(For example: Can you take meals or shakes with you to work?)

(e.g., sauces, sweeteners, coffee creamers, sodas, powdered juices)

1 is Not hungry at all, 5 is Starving

1 is Sedentary, 10 is I take exercising very seriously

1 is I'm always relapsing, 10 is I'm flawless

Female example: I’d like to develop my upper body a bit, but not my chest. As for my lower body, I think my legs are already big enough, so we can focus on glutes and calves. Male example: I feel like my back is disproportionately bigger than the rest of my body. I’d like to even out the other muscle groups while maintaining my back as it is. Increasing my arms would also be a good idea.

List past and current usage.

List past and current usage. (e.g., coffee, caffeine, pre-workouts, fat burners, amphetamines)

Rate the items below from 0 to 10, where 0 means very poor and 10 means excellent.

0 is Worst, 10 is Best

If you're answer is "NO" to all of the questions above, then you are safe to participate in physical activities.

If you answer "YES" to one or more questions, then you need to consult your doctor to clarify if you're capable of doing physical activities on your current state.

1. If you have any health issue, ALWAYS consult your doctor before beginning this or any other exercise program, especially if you have any chronic or recurring condition, and/or if you are pregnant, nursing, or elderly. This exercise program is NOT recommended if you experience chest pains or have uncontrolled blood pressure or other uncontrolled chronic diseases.
2. By performing any of the exercises in this program, you assume ALL risks of injury from doing so. The Blauth Concept is NOT responsible or liable for any injury or loss you may sustain by participating in this exercise program.
3. Stop exercising immediately if you experience pain, soreness, fatigue, shortness of breath, dizziness, lightheadedness, blurred vision, headache, nausea, sickness, illness, dehydration, excessive sweating, or any other discomfort. If any of these symptoms persists after you stop exercising, seek medical help immediately.
4. These exercise programs are NOT intended, and should NOT be used, as a substitute for professional medical advice, diagnosis or treatment.
5. The Blauth Concept makes NO representation or warranty, whether express or implied, with respect to the safety, usefulness, or the result of this exercise program.
6. I am not a medical professional. As a fitness coach, I am not providing healthcare, medical, or nutritional therapy services or attempting to diagnose, treat, prevent, or cure any physical, mental, or emotional issue.
7. The information provided on this service is for informational purposes only and is not intended to substitute professional medical advice, diagnoses, or treatment. Always seek advice from your physician or other qualified healthcare provider before undertaking a new health regimen.
8. Do not disregard medical advice or delay seeking medical advice because of information you read on this coaching service. Do not start or stop any medications without speaking to your medical or mental health provider.
9. Although I am a certified nutrition and exercise coach, I am not your doctor/dietitian/therapist/etc. All information on this service is for informational purposes only, does not constitute medical advice, and does not establish any kind of patient-client relationship.
10. I don’t make any guarantees about the results of the information applied on this service. I share educational and informational resources that are intended to help you succeed in body transformation. You nevertheless need to know that your ultimate success or failure will be the result of your own efforts, your particular situation, and innumerable other circumstances beyond my knowledge and control.
11. If you have been going through difficult times and are therefore unable to follow the plan, you can freeze it and resume the remaining period whenever you want.
12.If you have diligently followed all the steps mentioned on the 8 Week Guarantee page and are not satisfied with your results after 8 weeks, you can request a refund.

By signing I agree with all the information above.