Health History Intake Form

All new clients registering for any class or service must complete a health history form prior to receiving services.

Please complete the form by visiting client resources under the 'more'

 

Consent for Training

I have enrolled in a program of physical conditioning and instruction in Pilates and Personal Training. I have been advised and I understand that Personal Training and Pilates, like any exercise program, present some unavoidable risk of injury, especially to people who have pre-existing injuries or medical disabilities. I understand that use of exercise equipment also carries with it a risk of injury. I recognize that many changes may occur as a result of Personal Training and Pilates, including possible short-term aggravation of some symptoms, feelings of tiredness, soreness, light-headedness, changes in energy level, mood changes, etc. I also understand that a medical evaluation is advisable before commencing in any exercise program.

 

I have and will continue to keep Limber Arts and any associated practitioner fully informed of any physical condition or disability that would prevent or limit my participation in any exercise program. If I experience any pain or discomfort during a session, I will immediately inform my practitioner. I further understand that Personal Training and Pilates should not be construed as a substitute for medical examination, diagnosis, or treatment and that I should see a physician, chiropractor, or other qualified medical specialist for any mental or physical ailment of which I am aware.

 

It is expressly agreed that all use of facilities and equipment with and under the guidance of Limber Arts practitioners shall be undertaken by me, the client, at my own sole risk. It is also expressly agreed that Limber Arts and its practitioners/trainers shall not be liable for any injuries or any damages to me or guest, or be subject to any claim, demand, injury or damages whatsoever, including--without limitation--those damages resulting from acts of active or passive negligence on the part of Limber Arts or its agents. Client, for himself/herself and on behalf of his/her executors, administrators, heirs, and successors waives any possible liability of Limber Arts, its owner, or its agents from all such claims, demands, injuries, damages, actions or courses of action.

 

I certify that I have informed any practitioner or trainer of any pertinent health history and that I have completed a health history form prior to receiving services through Limber Arts.  I agree to keep my practitioner updated as to any changes in my medical profile and understand that there shall be no liability on the practitioner’s part should I fail to do so. Understanding all of this, I give my consent to receive care.

 

Appointment and Cancellation Policies

I agree to pay the amount due prior to or at the appointment time. All returned checks will be charged a $25 fee.

 

Notification of cancellation, or requests for rescheduling of an appointment must occur at least 24-hours in advance of the session start time to avoid a late cancel charge.  Each client will be given one complimentary exemption to the late cancelation policy, after which point there will be no exceptions.

 

A late cancel charge is equal to the full value of the session or class. If I have purchased a multi-class or multi-session package, I understand that one session will be taken from my package to account for the late cancel charge. If I do not hold a package, I understand that I will owe the full value of the class or session.

 

I agree that it is my responsibility to record dates and times of any upcoming appointments, and that failure to receive reminders from Limber Arts or associated practitioners does not constitute a reason to withhold payment for a missed/late-canceled session.

 

I understand that late arrival or early departure from a scheduled session will not reduce the fee, or change the session end time. My practitioner will wait for 15 minutes from the scheduled start time, after which, the practitioner is free from obligation and I will be charged the full amount of the scheduled session.

 

If I arrive later than 10 minutes after the scheduled start time of a group class or workshop, I understand that, for my safety, this may mean that I cannot join the class, at the instructor's discretion.

 

Single sessions are paid for prior to, or at the time of the appointment. We offer promotional packages, which have clearly specified expiration date which will not be extended. There will be no refunds for unused package sessions.

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