Welcome to Studio F.I.T.! Congratulations on your decision to hire a personal trainer to assist you on your journey to improved fitness! Although this is the most important step that you have taken, here are some other things that you should consider to ensure your success on your journey to optimal fitness: Schedule a basic fitness assessment with your trainer. Your fitness assessment will not only benchmark where you started and track your progress every 4 to 6 weeks for the next 3 months, but it will include your fitness goal(s) based on your benchmark as well as your exercise prescription, i.e. what other exercise you should be doing to meet your established fitness goals. Cost: $100 every 3 months. Start writing down what you eat; this is essential to your success. Ask your trainer to review at least 3 to 5 days of your eating journal and provide you with feedback. If you are having difficulty making healthy food choices ask your trainer about our nutrition programs. Cost: No additional charge for your trainer to review your journal. Portion Containers and corresponding programs start at $20. Please let us know if you have any questions, comments or concerns. We are here to ensure your success! The Studio F.I.T. team

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Regular physical activity is fun and healthy, and increasingly more people are starting to become more active everyday. Being more active is very safe for most people. However, some people should check with their doctor before they start becoming much more physically active.

If you are planning to become much more physically active than you are now, start by answering the seven questions in the box below. If you are between the ages of 15 and 69, the PAR-Q will tell you if you should check with your doctor before you start. If you are over 69 years of age and you are not used to being very active, check with your doctor.

Common sense is you best guide when you answer these questions. Please read the question carefully and answer each one honestly by checking YES or NO.

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Has your doctor ever said that you have a heart condition and that you should only do physical activity recommended by a doctor?

YES NO

Do you feel pain in your chest when you do physical activity?

YES NO

In the past month, have you had chest pain when you were not doing physical activity?

YES NO

Do you lose your balance because of dizziness or do you ever lose consciousness?

YES NO

Do you have a bone or joint problem that could be made worse by a change in your physical activity?

YES NO

Is your doctor currently prescribing drugs (for example, water pills) for your blood pressure or heart condition?

YES NO

Do you know of any other reason why you should not do physical activity?

YES NO

If you answered yes to one or more questions

Talk with your doctor by phone or in person BEFORE you start becoming much more physically active or BEFORE you have a fitness appraisal. Tell your doctor about the PAR-Q and which questions you answered YES.

You may be able to do any activity you want - as long as you start slowly and build up gradually. Or, you may need to restrict your activities to those which are safe for you. Talk with you doctor about the kinds of activities you wish to participate in and follow his/her advice.

No to all questions

If you answered NO honestly to all PAR-Q questions, you can be reasonably sure that you can:

Start becoming much more physically active. Begin slowly and build up gradually. This is the safest and easiest way to go.
Take part in a fitness appraisal. This is an excellent way to determine your basic fitness so that you can plan the best way for you to live actively.

Delay becoming much more active:

If you are not feeling well because of a temporary illness such as cold or a fever - wait until you feel better; or if you are or may be pregnant - talk to your doctor before you start becoming more active.

Please note: If your health changes so that you then answer YES to any of the above questions, tell your fitness or health professional. Ask whether you should change you physical activity plan.

Informed Use of the PAR-Q.

STUDIO F.I.T. assumes no liability for persons who undertake physical activity, and if in doubt after completing this questionnaire consult your doctor prior to physical activity. I have read, understood and completed this questionnaire. Any questions I had were answered to my full satisfaction.

Signature for PAR-Q *

TODAY'S DATE: *

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For most people, physical activity should not pose any problem or hazard. The following questions are designed to identify the small number of adults for whom physical activity might be inappropriate or those who should have medical advice concerning the type of activity most suitable for them. Common sense is your best guide in answering these questions. Pleease read them carefully and check the “Yes” or “No” response opposite the question if it applies to you.

1. Are you over age 55 and/or not accustomed to vigorous exercise?

YES NO

2. Are you or have you ever been a diabetic?

YES NO

3. Are you now pregnant, or have you been pregnant within the last 3 months?

YES NO

4. Have you had any surgery in the last 3 months?

YES NO

5. Have you been hospitalized in the last 2 years?

YES NO

If 'YES', when and why?

6. Have you ever seen a chiropractor, acupuncturist, or other alternative medicine practitioner?

YES NO

If 'YES', when and why?

Please check the box if you have ever experienced any of the following symptoms:

Have you ever experienced any of the following symptoms:

Pain or discomfort in the chest Unaccustomed shortness of breath Dizziness Labored or uncomfortable breathing, with or without pain Swollen ankles Heart palpitations Heart murmur Limping

If yes to any, please explain when first experienced and treatment used:

Do you have high blood pressure? If yes, are you current on blood pressure medication?

YES NO

Is your total serum cholesterol level over 220?

YES NO

Do you smoke?

YES NO

Have you ever smoked?

YES NO

If 'YES' When did you stop?

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Do you have diabetes?

YES NO

Do you have a family member who has had coronary or atherosclerotic disease before age 55?

YES NO

Do you have pain or discomfort in your back? If so, Left or Right

YES NO LEFT RIGHT

Do you have pain or discomfort in your knee?If so, Left or Right

YES NO LEFT RIGHT

Do you have pain or discomfort in your shoulder?If so, Left or Right

YES NO LEFT RIGHT

Do you have pain or discomfort in your elbow?If so, Left or Right

YES NO LEFT RIGHT

Do you have pain or discomfort in your ankle?If so, Left or Right

YES NO LEFT RIGHT

If you checked “Yes” above, please describe your pain. On a scale of 1 to 10, with 1 being almost nonexistent and 10 being excruciating, how severe is it? Does it get more or less severe as the day goes on? When do you notice it? What really aggravates it?

Have you ever torn ligaments or cartilage in your knee?

YES NO

If so, when?

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Did you have surgery on this knee?

YES NO

If so, when?

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Have you ever had shoulder surgery? If so, which shoulder? When?

Have you ever had a neck injury, such as whiplash? If so, when?

Have you ever been treated for a spinal disk injury? If so, when?

Do you ever experience tingling or numbness in your elbows or hands?

YES NO

What is the present state of your general health?

EXCELLENT GOOD FAIR POOR

I certify that I understand the foregoing questions and my answers are true and complete. I also understand that this information is being provided as part of my initial consultation and may or may not be periodically updated.
I assume the risk for any changes in my medical condition that might affect my ability to exercise.

Signature for Health History Questionnaire *

TODAY'S DATE: *

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If you answered yes to one or more questions and you have not recently consulted with your doctor, do so before beginning an exercise program. Tell your doctor which questions you answered yes to and explain that you plan to undergo an exercise program that may include, but may not be limited to, weight and/or resistance training. After medical evaluation, ask your doctor 1. which activities you may safely participate in, and 2. what specific restrictions, if any, should apply to your condition and which activities and/or exercises you should avoid. I acknowledge that I have read the foregoing statements and understand the content thereof.

Signature Regarding Doctor Consultation *

TODAY'S DATE: *

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Have you ever been on a diet? If so, please answer the following questions:

How many diets have you been on in the last 2 years?

Describe any diets you’ve been on. Did you go to a commercial weight-loss service (Jenny Craig, Diet Center, etc.)? Did you follow a diet from a book or article? If so, which one?

Describe your experience with diets. Did you lose weight? Did you gain any of it back? How was your energy level?

Do you ever eat when you aren’t hungry? If so, when?

Do you read food labels?

YES NO

Are you currently involved in a regular exercise program?

YES NO

Do you participate in any form of regular aerobic exercise?

YES NO

If yes, average amount of time spent per workout session:

Do you regularly perform resistance training?

YES NO

If yes, number of days per week:

Would you characterize your life as:

Low Stress Moderately Stressful Highly Stressful

Any other regular physical activity in the last 2 years?:

YES NO

Rate yourself on a scale of 1 to 5 (1 indicating the lowest value and 5 the highest). Circle the number that applies the most.

Characterize your present physical fitness level:

Characterize your present cardiovascular capacity:

	1	2	3	4	5
Lowest						Highest

Characterize your present muscular capacity:

	1	2	3	4	5
Lowest						Highest

Characterize your present flexibility capacity:

	1	2	3	4	5
Lowest						Highest

Do you start exercise programs but then find yourself unable to stick with them?

YES NO

How much time are you willing to devote to an exercise program?

Check items that are important to you:

Informed Consent for Exercise Testing

This form is an important legal document. It explains the risks you are assuming by beginning an exercise testing program. It is critical that you read and understand it completely. After you have done so, please print your name legibly and sign in the spaces provided at the bottom.

I hereby voluntarily give consent to engage in a fitness test. I understand that the cardiovascular fitness test will involve progressive stages of increasing effort and that at any time I may terminate the test for any reason.

I understand that during some tests I may be encouraged to work at maximum effort and that at any time I may terminate the test for any reason.

I understand there are certain changes which may occur during the exercise test. These changes could possibly include abnormal blood pressure, fainting, disorders of heart beat, and, in very rare instances, heart attack.

I understand that every effort will be made to minimize problems by preliminary examination and close observation during testing.

I understand that I am responsible for monitoring my own condition throughout testing, and should any unusual symptoms occur, I will cease my participation and inform the test administrator of the symptoms. Unusual symptoms include, but are not limited to: chest discomfort, nausea, difficulty in breathing, and joint or muscle pain or injury.
Also, in consideration of being allowed to participate in the fitness tests, I agree to assume all risks of such fitness testing, and hereby release and hold harmless STUDIO F.I.T. and their agents and employees, from any and all health claims, suits, losses, or causes of action for damages, for injury or death, including claims for negligence, arising out of or related to my participation in the fitness assessments.

I have read the foregoing carefully and I understand its content. Any questions which may have occurred to me concerning this informed consent have been answered to my satisfaction.

Signature on Informed Consent for Exercise Testing *

TODAY'S DATE: *

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Waiver, Release, and Assumption of Risk Form

This form is an important legal document. It explains the risks you are assuming by beginning an exercise program. It is critical that you read and understand it completely. After you have done so, sign in the space provided at the bottom of the page.

Waiver, Informed Consent, and Covenant Not to Sue

I have volunteered to participate in a program of physical exercise under the direction of STUDIO F.I.T. which will include, but may not be limited to, weight and/or resistance training. In consideration of STUDIO F.I.T. agreement to instruct, assist, and train me, I do here and forever release and discharge and hereby hold harmless STUDIO F.I.T.and their 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 THAT MAY MALFUNCTION OR BREAK (2) ANY SLIP, FALL, DROPPING OF EQUIPMENT AND (3) OR NEGLIGENT INSTRUCTION OR SUPERVISION.

Assumption of Risk

I recognize that exercise might be difficult and strenuous and that there could be dangers inherent in exercise for some individuals.

I acknowledge that the possibility of certain unusual physical changes during exercise does exist. These changes include abnormal blood pressure; fainting; disorders in heartbeat; heart attack; and, in rare instances, death.

I understand that as a result of my participation in an exercise program, I could suffer an injury or physical disorder that could result in my becoming partially or totally disabled and incapable of performing any gainful employment or having a normal social life.

I recognize that an examination by a physician should be obtained by all participants prior to involvement in any exercise program. If I have chosen not to obtain a physician’s permission prior to beginning this exercise program with STUDIO F.I.T., I hereby agree that I am doing so at my own risk.

In any event, I acknowledge and agree that I assume the risks associated with any and all activities and/or exercises in which I participate.

I acknowledge and agree that no warranties or representations have been made to me regarding the results I will achieve from this program. I understand that results are individual and may vary.

Further, it is understood that parts of this class may be recorded and/or pictures taken either of which may be posted on the STUDIO F.I.T. website. If you would prefer not to be featured in pictures and/or recordings, please notify me so you can be placed in the class accordingly.

I ACKNOWLEDGE THAT I HAVE THOROUGHLY READ THIS WAIVER AND RELEASE AND FULLY UNDERSTAND THAT IT IS A RELEASE OF LIABILITY. BY SIGNING THIS DOCUMENT, I AM WAIVING ANY RIGHT I OR MY SUCCESSORS MIGHT HAVE TO BRING A LEGAL ACTION OR ASSERT A CLAIM AGAINST STUDIO F.I.T. FOR YOUR NEGLIGENCE OR THAT OF YOUR EMPLOYEES, AGENTS, OR CONTRACTORS.

Signature Waiver, Risk and Assumption form *

TODAY's DATE *

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LETTER OF AGREEMENT FOR PERSONAL TRAINING & CLASSES This Agreement is made and entered into this __day of _______________, by and between ________________ (“Client”) and Studio F.I.T. of Tampa Bay, physically located at 2136 Ashley Oak Circle, Wesley Chapel, FL 33544 (“Company”). In consideration of the mutual promises exchanged herein and other goods and valuables consideration, the parties agree as follows:

1 Client(s) and Company have agreed that he/she will conduct 30 or 60 minute workout sessions unless otherwise agreed to.
Each session will begin at a mutually convenient, agreed-upon time and shall be subject to the policies (“Company Policies”) attached.
All workout sessions must be completed within thirty (30) days of this agreement otherwise they will be forfeited.

2.Client(s) will pay Company the sum agreed for these sessions. Client acknowledges that if these sessions are shared with other paying clients, that cancelations and/or reschedules must be coordinated amongst the participating clients.
It is agreed that no credit or refund shall be due for sessions cancelled by Client, except as provided in the Policies posted.

3. Concurrently with the execution of this Agreement, Client has executed and delivered to Company a Waiver and Assumption of Risk Agreement, in which Client assumes the risk of participating in an exercise program and agrees that Company and its agents, employees, or contractors, if any, shall have no liability for any injury, illness, or similar difficulty that Client may suffer arising out of or connected with Client’s participation in Company’s program. Client hereby acknowledges and agrees that the execution and delivery of the Waiver Agreement are material inducements to Company permitting Client to participate in Company program and agrees to be bound by same.

4. Client(s) and Company may agree to conduct additional sessions at such times and locations as they may agree upon, and in such event (i) the provisions of this Agreement, including the Company Policies attached, shall be deemed to apply to such additional sessions and (ii) Client will pay Company in advance, the sum of $__ per __ minute session. Client acknowledges and agrees that no credit or refund shall be due for sessions cancelled by Client, except as provided in the Company Policies.

5. Client(s) has the right to cancel this agreement within 3 days without penalty, exclusive of holidays and weekends. In addition, if Company goes out of business or moves it’s facilities more than five (5) driving miles from the current location, client has the right to cancel this agreement and receive a refund that shall be an amount equal to the contact price divided by the number of weeks in the contract term and multiplying the result by the number of weeks remaining in the contract term. Contact the Florida Department of Agriculture & Consumer Services for more information within sixty (60) days should Company go out of business. The business location shall not be deemed out of business when temporarily closed for repair and renovation of the premises: 1) Upon sale, for not more than 14 consecutive days or 2) during ownership, for not more than seven consecutive days and not more than two periods of seven consecutive days in any calendar year. Further, if client dies or becomes physically unable to avail himself of a substantial portion of the contracted services which was used from the commencement of the contract until the time of disability, client has the right to cancel with refund of funds paid or accepted in payment of the contract in an amount computed by dividing the contract price by the number of weeks remaining in the contract term.

6. All cancelation requests must be in writing to the Company and shall also terminate obligations to any entity to whom Company has subrogated or assigned this agreement. Once a cancelation request is received, client will receive a full refund of all monies paid under the agreement unless services have been rendered. If services have been rendered, Company may retain an amount computed by dividing the number of occasions services are to be rendered into the total contract price and multiplying the result by the number of complete days that have passed since the making of the contract or, if appropriate by the number of occasions that services have been rendered. A refund shall be issued within thirty (30) days after receipt of the notice of cancellation made.

7. SHOULD YOU (CLIENT) CHOOSE TO PAY FOR MORE THAN ONE (1) MONTH OF THIS AGREEMENT IN ADVANCE, BE AWARE THAT YOU ARE PAYING FOR FUTURE SERVICES AND MAY BE RISKING LOSS OF YOUR MONEY IN THE EVENT THIS HEALTH STUDIO AND/OR COMPANY/BUSINESS LOCATION CEASES TO OPERATE. THIS HEALTH STUDIO IS NOT REQUIRED BY FLORIDA LAW TO PROVIDE ANY SECURITY AND THERE MAY NOT BE OTHER PROTECTIONS PROVIDED TO YOU SHOULD YOU CHOOSE TO PAY IN ADVANCE.

Studio F.I.T. of Tampa Bay is registered with the state of Florida as a Health Studio; Registration # HS8402.

Our Mailing Address and Primary Business Location is 2136 Ashley Oak Circle, Wesley Chapel, FL 33544

IN WITNESS WHEREOF, Client and Company have caused this Agreement to be executed on the day and year first above written and terminating thirty (30) days thereafter.

BY: Studio F.I.T. of Tampa

Signature on Letter of Agreement for Personal Training and Classes *

TODAY'S DATE: *

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STUDIO F.I.T. POLICIES

1. In addition to this form, Client will be required to sign and return the following forms prior to receiving a Fitness Consultation, Training Program Design, or beginning any Personal Training program: a. Waiver, Release, and Assumption of Risk Form b. Waiver, Release, and Assumption of Risk (Home Workouts) c. Informed Consent for Exercise Testing d. Letter of Agreement e. Physical Activity Readiness Questionnaire (PAR-Q) f. Health History Questionnaire
2. If you have any of the following physical conditions, you may be required to have a Medical Clearance and Physician’s Consent Form: a. Hypertension (>145/95 mm Hg) b. Hyperlipidemia (cholesterol >220 mg/dl or a total cholesterol-to-HDL ratio of >5.0) c. Diabetes d. Family history of heart disease prior to age 60 e. Smoking f. Abnormal resting EKG g. Any other condition that STUDIO F.I.T. in its sole discretion may deem to present an unreasonable risk to your health, were you to participate in a fitness evaluation or program.
3. Unless other arrangements are made, Personal Training sessions, and Program Design explanations (these services herein individually and collectively referred to as “sessions”) last approximately sixty minutes for 1 hour sessions and 30 minutes for ½ hour sessions. In order to provide the best service to all Clients, we cannot commit to extending any particular session beyond its previously scheduled time. In those cases where schedules do permit, Clients may request to extend sessions beyond sixty minutes (30 minutes for ½ hourly sessions) at the current session rates.
4. Rates for services are subject to change. Services prepaid for by Client, which are unused at the time of any rate change, will be honored at the price already paid.
5. Time slots are available on a “first-come, first-served” basis by appointment. Sessions, whether purchased a la carte or as part of a package, must be paid for when the appointment is booked. Client may schedule prepaid sessions in advance.
6. In order to provide the best possible service to all Clients, we ask that all Clients be ready to begin their session at the scheduled time. Time lost at the beginning of a session due to a Client’s tardiness cannot be made up at the end of the session as that could potentially impact the next scheduled Client. Unless prior arrangements have been made, a Client will be deemed a “noshow” when they are fifteen minutes late for an appointment. No refunds or credits will be given for “no-shows”.
7. Regarding cancellations: a. All qualifying cancellations will result in a credit being given which can be applied to a future session or other product or service. b. All cancellations must be made with a minimum of 48 hours advance notice in order to receive credit for the session. Due to an inability to fill the previously blocked time period, Cancellations with less than 48 hours notice given will not qualify for a credit and Client will be charged for the session. Cancellations must be made by contacting trainer by phone in order for it to be valid. c. If Client receives credit for a missed session, the credit must be used within 30 days of the missed session, or it will be waived.

8. Payment is due at the time the appointment for a session is booked. We accept cash, checks (subject to bank fees if checks do not clear), credit cards & Paypal.
9. Clients are required to observe any and all rules of the facility where workouts take place, if applicable.
10. Shirts and shoes are required at all times during sessions. Client should also have a towel and water available as necessary during the workout.
11. Clients have the right to terminate a particular exercise or workout at any time. You are in control of your workouts! If an exercise is uncomfortable or painful, or if you want to stop for any reason, you may do so. If a particular exercise is painful for you to do or you have an injury or other limitation that makes it difficult for you to do, trainer can attempt to substitute another exercise to work that particular muscle group.
12. You will get from your workouts what you put in. Results will vary by individual and trainer cannot guarantee specific results. Client acknowledges that Client is responsible for their decisions regarding whether or not to exercise consistently, eat properly, rest enough, and live a healthy lifestyle. 13. STUDIO F.I.T. respects your privacy. Due to the nature of our services, it is necessary to collect certain personal information from Clients. All information collected is treated as STRICTLY CONFIDENTIAL, and STUDIO F.I.T will not share or redistribute your information with any third party except as necessary to provide services purchased by the Client, or as required by law. Any information gathered from a Client is simply for our records and, if applicable, necessary to provide the services to the Client for which we have been contracted.

13. If trainer needs to cancel a scheduled session, Client will receive credit for such session.

Signature: Studio F.I.T. of Tampa Policies: *

Today's Date *

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IF YOU WOULD LIKE TO PAY FOR YOUR FITNESS ASSESSMENT, CLICK ON BUTTON ON RIGHT

Fitness Assessment $ 100.00

IDLife is a nutrition and supplement organization with a personalization of vitamins to enhance your lifestyle. If you're interested in taking a "FREE" self assessment, please click below, it will redirect you to the website... click on "Free Assessment"

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Physical Activity Readiness Questionnaire (PAR-Q) A Questionnaire for People Aged 15 to 69

If you answered yes to one or more questions

No to all questions

Delay becoming much more active:

Informed Use of the PAR-Q.

Health History Questionnaire

Lifestyle Questionnaire

Characterize your present physical fitness level:

STUDIO F.I.T. POLICIES