SPORTS PERFORMANCE WAIVER
Team Name
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Client Information:
Today's Date:
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Month
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Day
Year
Date
Client Name
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First Name
Last Name
Birth Date:
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Month
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Day
Year
Date
Age:
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Gender
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Male
Female
Address
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Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Cell Phone:
*
Email:
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example@example.com
Sports Played (Put N/A if not applicable)
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Emergency Contact Information:
Name:
*
Relationship:
*
Phone:
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Physical Activity Readiness
Please list any health conditions you have that your performance coach should be aware of (including, but not limited to asthma, syncope, diabetes, high/low blood pressure, seizures, heart/lung conditions, etc.):
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Medical Waiver
I, the above enrolled, understand that neither Rock and Armor Physical Therapy and Sports Performance, nor anyone employed by the facility will assume responsibility for accidents and/or other expenses incurred as a result of participation in this program, and regardless of location of the training program (clinic setting, court setting, field setting, etc.). I attest that the above is in good health and able to participate in a vigorous athletic program. In the event of injury or illness, the facility has my permission to provide emergency first aid care and seek the appropriate care necessary.
Client's Signature
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(Parent or guardian if client is under the age of 18)
Date
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Month
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Day
Year
Date
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Cancellation Policy for Personal Training
I agree to abide by a 24-hour cancellation notice for any scheduled session. I understand I may be charged up to the full amount of service for any missed sessions or for any cancellations with less than a 24-hour notice. I understand that if I arrive late, the session will end at the original scheduled time to prevent penalizing another client.
Payment Policy
Individual Sessions:
I agree that all individual and group sessions must be paid for up front prior to all training sessions. I will schedule all training sessions at Rock and Armor only after payments have been received. As noted above, I understand that we will be charged for all no-show sessions or late cancels.
Classes:
I understand that all individuals participating in Rock and Armor classes must enroll in monthly Auto Pay. I can do this over the phone or at our front desk. I agree that my credit/debit card will be billed monthly for that month's training. In the event I/my athlete is no longer training at Rock and Armor, we understand that Rock and Armor can suspend or delete our autopay at that time by calling Rock and Armor, or by directly speaking with them in person. Our auto pay can be re-activated at any time for future training sessions. I understand it is our responsibility to cancel Rock and Armor auto pay, either over the phone, or in person. I agree that we will not be reimbursed for any months paid for, but not utilized.
I understand that this class is offered at a fixed monthly rate, and that the cost will remain the same regardless of my level of attendance or participation. The price is not subject to change based on how frequently I attend, ensuring that the fee remains consistent throughout the duration of my enrollment.
Client's Signature
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(Parent or guardian if client is under the age of 18)
Date
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Month
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Day
Year
Date
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