Program Training Only

Name
First Last
Email
Gender*

Age*
Height (in)*
Weight (lbs)*

Describe your fitness background and experience*
Prerequisite - Must be familiar with Flexible Dieting, and experienced in counting and tracking macros.*
How experienced are you with compound lifts, i.e., Squat, Press, Deadlift, Hip Thrust, Glute Bridge, Lunges, Rows, Pull-ups, Push-ups including variations of all?*
Prerequisite - Must have experience with strength training.
What are you looking for in a coach?*

Have you worked with a coach or trainer before? If so, what did you like and what did you not like?*
When it comes to motivation, we all have a “Why.” What is your “Why” for your commitment to life-change and coaching?*
What inspired you to contact Rachel for coaching?*

What has held you back in your commitment to achieving and pursuing a healthy lifestyle?*
Choose coaching option are you interested in:*
What is your current activity level?*
Please describe what your primary fitness goal is:*
Training Frequency & Programming*
How many days per week do you prefer to strength train? Do you have time constraints on any of your training days?
Please describe what your primary fitness goal is:*

Do you have any existing injuries or conditions that I should be aware of?*
If a doctor or a physical therapist has restricted you from lifting weights, or if you have a condition that prevents you from safely lifting weights, then I am unable to design your programming.
Online coaching is a relationship between both parties (coach/client) working towards the same goal, becoming your best self. As the prerequisites state, all individuals must have experience with consistency, strength training, macro tracking and adherence. Results are contingent upon your ability to adhere to both strength training and macro tracking. Do you consider your experience with both, Strength Training AND Macro Tracking at a level you can consistently and successfully follow the coaching programs?*

ASSUMPTION OF RISK, WAIVER AND RELEASE OF LIABILITY, AND INDEMNITY AGREEMENT DECLARATIONS:*
This Agreement is entered into between personal trainer Rachel M. Brooks (“Trainer”) and the undersigned (“Client”). The provision of personal training services by Trainer to Client, and Client’s use of any premises, facilities or equipment are contingent upon this Agreement.

ASSUMPTION OF RISK: You agree that if you engage in any physical exercise or activity, including personal training, or enter our premises or use any facility or equipment on our premises for any purpose, you do so at your own risk and assume the risk of any and all injury and/or damage you may suffer, whether while engaging in physical exercise or not. This includes injury or damage sustained while and/or resulting from using any premises or facility, or using any equipment, whether provided to you by Trainer or otherwise, including injuries or damages arising out of the negligence of Trainer, whether active or passive, or any of Trainer’s affiliates, employees, agents, representatives, successors, and assigns. Your assumption of risk includes, but is not limited to, your use of any exercise equipment (mechanical or otherwise), sports fields, courts, or other areas, locker rooms, sidewalks, parking lots, stairs, pools, whirlpools, saunas, steam rooms, lobby or other general areas of any facilities, or any equipment. You assume the risk of your participation in any activity, class, program, instruction, or event, including but not limited to weightlifting, walking, jogging, running, aerobic activities, aquatic activities, tennis, basketball, volleyball, racquetball, or any other sporting or recreational endeavor. You agree that you are voluntarily participating in the aforementioned activities and assume all risk of injury, illness, damage, or loss to you or your property that might result, including, without limitation, any loss or theft of any personal property, whether arising out of the negligence of Trainer or otherwise.

RELEASE: You agree on behalf of yourself (and all your personal representatives, heirs, executors, administrators, agents, and assigns) to release and discharge Trainer (and Trainer’s affiliates, related entities, employees, agents, representatives, successors, and assigns) from any and all claims or causes of action (known or unknown) arising out of the negligence of Trainer, whether active or passive, or any of Trainer’s affiliates, employees, agents, representatives, successors, and assigns. This waiver and release of liability includes, without limitation, injuries which may occur as a result of (a) your use of any exercise equipment or facilities which may malfunction or break, (b) improper maintenance of any exercise equipment, premises or facilities, (c) negligent instruction or supervision, including personal training, (d) negligent hiring or retention of employees, and/or (e) slipping or tripping and falling while on any portion of a premises or while traveling to or from personal training, including injuries resulting from Trainer’s or anyone else’s negligent inspection or maintenance of the facility or premises.

INDEMNIFICATION: By execution of this agreement, you hereby agree to indemnify and hold harmless Trainer from any loss, liability, damage, or cost Trainer may incur due to the provision of personal training by Trainer to you.

ACKNOWLEDGMENTS: You expressly agree that the foregoing release, waiver, assumption of risk and indemnity agreement is intended to be as broad and inclusive as permitted by the law in the State of Ohio and that if any portion thereof is held invalid, it is agreed that the balance shall, notwithstanding, continue in full legal force and effect. You acknowledge that Trainer offers a service to his/her clients encompassing the entire recreational and/or fitness spectrum. Trainer is not in the business of selling weightlifting equipment, exercise equipment, or other such products to the public, and the use of such items is incidental to the service provided by Trainer. You acknowledge and agree that Trainer does not place such items into the stream of commerce. This release is not intended as an attempted release of claims of gross negligence or intentional acts. You acknowledge that you have carefully read this waiver and release and fully understand that it is a release of liability, express assumption of risk and indemnity agreement. You are aware and agree that by executing this waiver and release, you are giving up your right to bring a legal action or assert a claim against trainer for trainer’s negligence, or for any defective product used while receiving personal training from trainer. You have read and voluntarily signed the waiver and release and further agree that no oral representations, statements, or inducement apart from the foregoing written agreement have been made.
- I Agree to The Terms

DISCLAIMER OF LIABILITY FOR COACHING*
Before Your Information Can Be Submitted, You Must Read And Acknowledge The Following Disclaimer.

Services
The services to be provided by Fitness and Lifestyle Coaching to the client are conducted online only, and may be conducted by email, text messages, videos, and other remote means of communication. Coaching may address developing a regimen of appropriate strength training exercise, and providing a suggested customized daily calorie intake. Because our coach is not a licensed nutritionist, those with certain medical problems such as diabetes, celiac disease, or other dietary restrictions are not eligible to participate in our programs, and are encouraged to seek professional medical advice.

Throughout the working relationship, the coach will engage in direct and personal conversations. The client understands that successful coaching requires a co-active collaborative approach between client and coach. In the coaching relationship, the coach plays the role of a facilitator of change, but it is the client's responsibility to enact or bring about the change.

If the client believes the coaching is not working as desired, the client will communicate this with the coach as soon as possible and the coaching strategy will be restructured to address the client’s desired outcome of coaching. You are very much encouraged to talk more with the coach as to receive a better understanding of what coaching is about and how to get the most out of it. Prior

History
The client is required to disclose any and all medical conditions as part of the initiation of our program, and must have a clean bill of health before commencing our programs. Failure to disclose medical conditions provides grounds for the immediate termination of services. The coach is not a registered psychologist or psychiatrist, nor a licensed therapist. The coach does not engage in therapy with coaching clients. The coach is also not a licensed nutritionist. In entering into the coaching relationship, and signing the agreement, you are agreeing that if any health difficulties arise during the course of the coaching relationship, you will notify the coach immediately so that the coach can discuss with you an appropriate referral.

Confidentiality
All information about the coach/client relationship will remain strictly confidential except in very rare circumstances where decreed by law; i.e. where the court might issue a subpoena for the file or information.

If you wish for me as your coach to speak to someone outside our interactions, you need to give me written permission (original letter, fax or email) to do so. Exceptions to confidentiality of course relate to circumstances such as intent to seriously harm someone, child abuse, thoughts of suicide etc. Otherwise, all remaining information is kept confidential.

Assumption of Risk
You agree that if you engage in any physical exercise or activity, including coaching, you do so at your own risk and assume the risk of any and all injury and/or damage you may suffer, whether while engaging in physical exercise or not. This includes injury or damage sustained while and/or resulting from using any premises or facility, or using any equipment, whether provided to you by the Coach or otherwise, including injuries or damages arising out of the negligence of the Coach, whether active or passive, or any of the Coach’s affiliates, employees, agents, representatives, successors, and assigns.

Release
You agree on behalf of yourself (and all your personal representatives, heirs, executors, administrators, agents, and assigns) to release and discharge Coach (and Coach’s affiliates, related entities, employees, agents, representatives, successors, and assigns) from any and all claims or causes of action (known or unknown) arising out of the negligence of the Coach, whether active or passive, or any of the Coach’s affiliates, employees, agents, representatives, successors, and assigns. This waiver and release of liability includes, without limitation, injuries which may occur as a result of (a) negligent instruction or supervision, including personal coaching, (b) negligent hiring or retention of employees, and/or (c) any other claims that may arise in the course of your personal coaching program.

Acknowledgments
You expressly agree that the foregoing release, waiver, and assumption of risk agreement is intended to be as broad and inclusive as permitted by the law in the State of Ohio and that if any portion thereof is held invalid, it is agreed that the balance shall, notwithstanding, continue in full legal force and effect. You acknowledge that the Coach offers a service to her clients encompassing the personal fitness and nutrition spectrum. This release is not intended as an attempted release of claims of gross negligence or intentional acts.

You acknowledge that you have carefully read this waiver and release and fully understand that it is a release of liability, express assumption of risk and indemnity agreement.

You are aware and agree that by executing this waiver and release, you are giving up your right to bring a legal action or assert a claim against the Coach for the Coach’s negligence. You have read and voluntarily signed the waiver and release and further agree that no oral representations, statements, or inducement apart from the foregoing written agreement have been made.
- I Agree to The Terms

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