Each participant must sign below waiver, complete nutritional pre-test, goals, and a health
history questionnaire to be kept on file and will be confidential between the personal trainer
and the client, unless individual client requests otherwise.
We will do scheduled sessions to ensure a lifestyle ensues past a single workout, or an “on-
notification” monthly schedule.
Jacqueline Carrizosa and client will meet at the agreed upon training indoor/outdoor venue
at the scheduled appointment time, unless an alternate meeting place as been agreed upon
between client and Jacqueline Carrizosa.
Client understands that healthy food consumption also partakes in desired results.
Client also understands this is a commitment with themselves and their own health and
Jacqueline Carrizosa will be available by phone or e-mail regarding questions with fitness or
nutritional consumption, unless otherwise notified to clients.
Payment must be made first prior to start of scheduled training and please made payable to
I have volunteered to participate in a fitness
program provided to me by (Jacqueline Carrizosa, Motivators), which may include, but may not be limited
to, resistance training, explosive movements, weighted training, flexibility, swimming, and aerobic or
cardiovascular exercise. In consideration of Jacqueline Carrizosa’s (Motivators) agreement to instruct and
train me, I do here now and forever release and discharge and hereby hold harmless Jacqueline Carrizosa
(Motivators) and her respective agents, heirs, assigns, contractors, and employees from any and all claims,
demands, damages, rights of action or causes of action, present or future, arising out of or connected with
my participation in this or any exercise program including any injuries resulting there from.
THIS WAIVER AND RELEASE OF LIABILITY INCLUDES, WITHOUT LIMITATION, INJURIES
WHICH MAY OCCUR AS A RESULT OF (1) EQUIPMENT BELONGING TO TRAINER OR
TO MYSELF THAT MAY MALFUNCTION OR BREAK; (2) ANY SLIP, FALL, DROPPING OF
EQUIPMENT; (3) AND/OR NEGLIGENT INSTRUCTION OR SUPERVISION.
I have been informed of, understand and am aware that
any exercise program, whether or not requiring the use of any exercise equipment, is a potentially hazardous
I also have been informed of, understand and am aware that any indoor/outdoor exercise and/or
fitness activities involve a risk of injury, as well as abnormal changes in blood pressure, fainting, and a
remote risk of heart attack, stroke, other serious disability or death, and that I am voluntarily participating in
these activities and using equipment and machinery with full knowledge, understanding and appreciation of
the dangers involved. I hereby agree to expressly assume and accept any and all risks of injury, regardless of
severity, or death.
I have been advised that an examination by a physician should be obtained by anyone prior to
commencing a fitness and/or exercise program, or initiating a substantial change in the amount of regular
physical activity performed. If I have chosen not to obtain a physician’s
consent prior to beginning this fitness program with Trainer, I hereby agree that I am doing so solely at my
own risk. In any event, I acknowledge and agree that I assume the risks associated with any and all fitness
related activities and/or exercises in which I participate. Release, Covenant Not to Sue, and Waiver Personal
Training involves an inherent risk of physical injury and the undersigned assumes all such risks. The
undersigned hereby agrees that for the sole consideration of Jacqueline Carrizosa, (Motivators) allowing
the undersigned to participate in the Personal Training Program for which or in connection with which
Jacqueline Carrizosa, (Motivators) has made available any equipment, facilities, grounds, or personnel for
such training, the undersigned does hereby release, covenant not to sue, and forever discharge Jacqueline
Carrizosa, (Motivators) and her officers, agents, and employees of any and for all claims, demands, rights,
and causes of action of whatever kind or nature including but not limited to negligence, unforeseen bodily
and personal injuries, damage to property, and the consequences thereof resulting from participation in any
way connected with such recreational programs and activities.
The undersigned understands that this Release, Covenant Not to Sue, Waiver, and Assumption of
Risk shall be effective from the date of signature until the effective termination of the personal training
services by Jacqueline Carrizosa, (Motivators). By signing this document, the undersigned hereby
acknowledges that he/she has read the above carefully before signing, and agrees to comply with all the
Additional Rental Fees may apply.