Intake Form

Please complete prior to your first appointment

WAIVER/RELEASE 

 

A. LIABILITY AND ASSUMPTION OF RISK

 

RESULTS PLUS FITNESS, LLC (COLLECTIVELY “THE CLUB”) IS NOT STAFFED BY LICENSED MEDICAL PROFESSIONALS. Physical exercise can be strenuous and may subject you, the client, member, or participant, (collectively “The Client”) and your guests to risk of injury; therefore, The Club urges all Clients and their guests to obtain a physical examination from a licensed professional before engaging in any new exercise or dietary program. The Client agrees to take full responsibility when participating in  physical exercise, engaging with any Results Plus Fitness amenity on or off the premises, or acting on any dietary recommendations, to include supplements, weight reduction and body enhancement products, and understands that such dietary modifications may cause changes to energy, stamina, appetite, and/or mood. The Client confirms that any participation, and use of The Clubs equipment and facilities is completely voluntarily, and The Client assumes all risks of injury, illness, or death.   

 

This waiver and release of liability includes, without limitation, all injuries which may occur, regardless of negligence, as a result of: (a) use of all amenities and equipment in the facility and participation in any activity, class, program, personal training and/or instruction; (b) sudden and unforeseen malfunctioning of any equipment; (c) instruction, training, supervision, or dietary recommendations; (d) slips and/or falls while in the club, or on the club premises, including adjacent sidewalks and parking areas; or (e) negligence associated with the presence or transmission of any bacteria, viruses, or infectious diseases.  

 

By checking the box below, you (“The Client”) acknowledge that you have carefully read and understand the The Club’s Waiver/Release of Liability, and expressly agree to release and discharge Results Plus FitnessLLC, its affiliates, employees, agents, representatives, successors, or assigns, from any and all claims or causes of action. You voluntarily waive any right that you may otherwise have to bring legal action against Results Plus Fitness, LLC, its affiliates, employees, agents, representatives, successors, or assigns for negligence, personal injury, or property damage as it relates to you or your guests. You will defend and indemnify The Club should your guest file a negligence, personal injury, or property damage claim against The Club, its affiliates, employees, agents, representatives, successors, or assigns, and will hold The Club harmless against any such claims. Should a court of law find that any part of this agreement is against public policy, or in violation of any state statute or legal precedent, the Client agrees to abide by the remainder of these terms.

 

B. PHOTOGRAPHY

 

Results Plus Fitness retains the right to occasionally photograph or film events, Client sessions, or trainers for promotional purposes. You affirm that photographs or videos taken on The Club premises shall become the property of The Club, and no form of remuneration, including royalties arising from the photographs, will be awarded. You ("The Client") waive your right to inspect or approve the photographs by which your likeness appears, and hold harmless, release, and forever discharge The Club from all claims, demands, and causes of action which you, your heirs, representatives, executors, administrators, or any other persons acting on your behalf or on behalf of your estate have or may have by reason of this authorization.

 

C. TARDINESS POLICY

 

All visits are 45 minutes in length, and begin promptly on the hour. The Client will be considered late when he or she has not previously cancelled, and arrives past the hour assigned for the session, regardless of prior phone, email or text message. Time missed will be considered time lost, and the scheduled session will not be extended past the 45 minutes scheduled. Should The Client expect to arrive for a session past the top of the hour, The Club requests that a courtesy call or text is made directly to the Trainer. Upon arrival, the session will carry on for the remaining minutes scheduled, but will not be extended.

 

D. CANCELLATIONS & REFUNDS

 

All appointments must be cancelled a minimum of 12 hours prior to start of session. Special consideration will be made in the event that The Client has a medical or family emergency. The Client is responsible for paying for cancelled sessions that do not meet these requirements. Memberships may be cancelled for a refund within 2 business days (or 48 hours) of application, less a $150.00 (USD) Cancellation Fee. UNUSED SESSIONS WILL NOT BE REFUNDED. In the event that The Client is traveling, or will be out of town for an extended period of time, membership may be frozen for up to 60 days, or may be transferred within 60 days to a family member. Membership will be regarded as inactive, and future sessions cancelled, following any 60 consecutive days of inactivity, and unused sessions will not be refunded. All requests for Cancellation, Refund, or Membership Freeze must be submitted to The Club in writing.

 

E. ACKNOWLEDGEMENT OF TERMS

 

By checking the box below and submitting this form, I declare that I am of legal age to consent, and have read, reviewed, and agreed to the above Waiver/Release. I submit this document voluntarily, and agree to the terms without any inducement.

RESULTS PLUS FITNESS

(203) 288-8822

3013 Dixwell Avenue
Hamden, CT  06518

United States

Serving New Haven, North Haven, West Haven, Hamden, Wallingford, Cheshire, East Haven, Orange, Woodbridge & Bethany.

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Regular Business Hours:
Monday - Friday: 5am - 8pm 
Saturday: 7am - 2pm
Sunday: by Appointment  

Contact us for a Free Consult.

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