Metanoia-KC LLC Client Agreement

Metanoia-KC LLC Client Agreement

Assumption of Risk, Waiver & Release of Liability, & Indemnity Agreement
Name

First NameLast Name
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Email
example@example.com
Phone Number

Area CodePhone Number
Preferred Contact
Email, Phone Call, or Text
Emergency Contact Information:
Name, Relation, Phone Number
Favorite Food(s)
Favorite Music While Working Out
Immediate Family Information
Name, Relation, Age
Please fully read the following agreement before continuing. All terms must be agreed upon before beginning service(s).
I have fully read, understand, and agree to all terms within Metanoia-KC LLC's ASSUMPTION OF RISK, WAIVER AND RELEASE OF LIABILITY, AND INDEMNITY AGREEMENT
I understand the services provided by Metanoia-KC LLC are in no way intended as medical advice or to serve as a substitute for medical and behavioral counseling. The recommendations provided should be used in conjunction with the guidance and care of your physician. Metanoia-KC LLC is not a physician, Nutritionist, or Registered Dietician, and the scope of consultation services does not include treatment or diagnosis of specific illnesses or diseases.
I understand if I need to cancel or reschedule a session, I MUST contact Metanoia-KC LLC via email (jennylynn@metanoia-kc.com) to notify 24-hours in advance. 24-hours is required for a cancellation and/or reschedule in order to receive credit for the session. Failure to cancel within this time frame or failure to show up for a session will result in being charged for the session, no exceptions.
Respecting Trainer and Metanoia Client schedules is important; I understand that I will be held accountable for my scheduled session time(s). We will begin promptly at the scheduled time. Should I be late or early, I will not receive a longer session.
I understand if I have a purchased a program (ex: 12-week fitness program and/or 4-week nutrition program), Metanoia-KC LLC has fully committed to my success and held a client spot for me for this time period. I must complete all sessions within the program time period, any sessions not completed will be forfeited. I understand if I purchased a set number of sessions, I have 6 months to use before expiration.
I understand there is a no-refund policy on all classes, sessions, programs, and/or packages purchased. I understand service will cease and be forfeited entirely should payment (in-full and/or payment plan) not be received. I also understand I cannot transfer classes, sessions, programs, and/or packages to another party.
I understand a commitment to my health and wellness will not always be fun and/or easy. When I may not be feeling it, I will dig deep to remind myself why I am on this current path and will hold myself accountable! I understand and know I am worth it!
Date

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Signature
Should be Empty: