INFORMED CONSENT:
BENEFITS
Participation in a regular program of physical activity has been shown to produce positive changes in a number of organ systems. These
changes include increased work capacity, improved cardiovascular efficiency, and increased muscular strength, flexibility, power and
endurance.
RISKS
I recognize that exercise carries some risk to the musculoskeletal system (sprains, strains, breaks) and the cardiorespiratory system
(dizziness, discomfort in breathing, heart attack). I hereby certify that I know of no medical problem (except those noted below) that
would increase my risk of illness and injury, even death, as a result of participation in a regular exercise program.
TESTING AND EVALUATION RESULTS
I understand that I will undergo initial testing to determine my current physical fitness status. The testing will consist of completing
this health inventory and being tested for muscular fitness and body composition.
I further understand that such screening is intended to provide KC180Fitness LLC with essential information used in the development of
individual fitness programs. I understand that my individual results will be made available only to me. I also understand that testing is
not intended to replace any other medical tests or the services of my physician. I will be provided a copy of all test results.
I may share the results with whomever I please, including my personal physician. By signing the consent form I understand that I am
personally responsible for my actions during my tenure at KC180Fitness LLC, and that I waive the responsibility of this center if I should
incur any injury as a result of my negligence.
OUR COMMITMENT TO YOUR PRIVACY
In conducting our business, we will create records regarding you and the services we provide to you. We are required by law to
maintain the confidentiality of health information that identifies you. We also are required by law to provide you with this notice
of our legal duties and the privacy practices that we maintain in our practice concerning your individually identifiable health information
(IIHI). By federal and state law, we must follow the terms of the notice of privacy practices that we have in effect at the time.
Our practice will obtain your written authorization for uses and disclosures that are not permitted by applicable law.
WAIVER OF LIABILITY
As a participant in this program, you represent that you have no congenital physical or mental health problems that will preclude participation in the services provided by KC180Fitness LLC specifically, you represent that you have no underlying cardiovascular, neurological, orthopedic or any other illness that will preclude participation in any training program. You assume risk with any/all of the fitness programs specified under this agreement provided by KC180Fitness LLC.
You also acknowledge that boot camps, cardiovascular exercise, martial arts, kick boxing, running, resistance training, timed events, obstacle courses, and any other related sports activities are an extreme test of one's mental and physical limits and carry with it potential for damage or loss of property, serious injury and death. You also understand the risks of participating in these types of events/activities, you are healthy enough to participate, and you have a regular medical physician that you can contact regarding any medical problems that you might develop. You expressly waive, release, discharge and agree not to sue (from any liability of death, disability, personal injury, or action of any kind) KC180Fitness LLC, Kri Chay, his assistants/instructors or any other guest or person acting on behalf of KC180Fitness LLC.
NON-COMPETE/ NON DIS-CLOSURE
As a member of KC180Fitness LLC, Sexy Back Boot Camps, you will be receiving privileged information intended for YOUR education, YOUR physical improvements and YOUR mental focus only. The KC180Fitness LLC program may NOT be reproduced, stored in a retrieval system, or transmitted, in any form or by means electronic, mechanical, photocopying, and recording. You also testify that you do not work in a competitive or similar fitness/ health field and have no immediate intentions or later intentions of developing a similar type of fitness program. Should you decide to disclose/use this information, you agree that you will be held liable for attorney fees.
MISSED DAYS/ ABSENSES
You may make up any missed days during your current course or the week after. Any unused days past the Boot Camps limit will be forfeited. You may NOT transfer your missed days to family members/friends, etc. You may not pro-rate any monthly fees because of missed days. Payments are due in full no matter how many days you miss or are able to make up.
PHOTO AND/OR VIDEO RELEASE/QUOTES
Action photos or videos may be taken throughout the program for purposes of promoting KC180Fitness LLC and Kri Chay. These photos/videos may be printed in newspapers, magazines, websites, commercials and other forms of advertising. You agree that these photos/videos are the property of KC180Fitness LLC and may be used at any time for promotional purposes. We will ask for your permission first before printing any individual "before and after photos/videos." You also agree that any quotes given in surveys will be used for promotional purposes only.
TRANSFERS/ CHANGES
Once enlisted into a course, you must complete that entire agreement/course before switching to a different course length. (i.e. You must complete one full Boot Camp phase (3-6 weeks) at the introductory rate before signing up/receiving the one-year rate. You may NOT transfer your Boot Camp of any length to another person, friend or associate.
REFUNDS/CANCELLATION
Refunds are only made if not satisfied with KC180Fitness LLC within the first 30 days of a clients first Boot Camp classes. If you have to cancel this agreement for ANY reason (sick, injury, family emergency, work change etc.) and are only signed up for one course Š you will still owe any remaining balance by the last day of Boot Camp. You may make up any missed days during the current boot camp or following Boot Camp. After that time, your unused days will be automatically forfeited. If you pay by check, you will still be responsible to either mail or hand-deliver any remaining balance to Kri Chay. If you have paid a deposit and are not able to start on the date requested, you may apply that deposit to another Boot Camp and have up to two Boot Camps to use that deposit. If unable to attend within that new time frame, you forfeit your deposit. If you wish to cancel/suspend/stop/quit training with KC180Fitness LLC after the initial first 30 day period from the first boot camp class, you can do so by paying a termination fee of $398 by cash or check paid to KC180Fitness LLC, after submitting a handwritten letter to the owner Kri Chay or speaking with him in person with the intent to cancel classes.
WINNING RULES
If you have won a Boot Camp via an auction or raffle or other prize, you must present your winning certificate number and the hard copy upon registration to avoid any additional fees. No matter how you have won your Boot Camp, there are no transfers or refunds. If you currently work or plan to work as a personal trainer, a group fitness instructor, or other similar health and fitness field, you are NOT eligible to attend KC180Fitness LLC - NO EXCEPTIONS.
PAYING BY CREDIT CARD
I understand that my credit card statement will read: Sexy Back Boot Camps. If for some reason my CC does not work, I will give a new card number as soon as I am notified to avoid any late charges. All CC payments are to made online through the company Volo Innovations. There will be a link on the website http://www.sexybackbootcamps.com through the Registration tab, or the website name given to me upon request.
PAYING BY CHECK
I understand that if I pay by check, I understand I am waiving my right to pay by credit card which has the benefits of easy tracking, no late fees. I will ensure that my check is hand delivered or mailed to the address of KC180Fitness LLC ON or BEFORE each payment is due.
LEGAL REMEDIES
I also understand that if KC180Fitness LLC needs to enforce the payment terms of this agreement by and through any legal remedies available; that besides the amount that I owe to KC180Fitness LLC, I will be responsible for any and all legal fees incurred by KC180Fitness LLC to enforce my financial obligations that I have agreed to. KC180Fitness LLC reserves the right to refuse service to anyone if they are not at a level of fitness appropriate to participate in the majority of activities and exercises. The same holds true if someone works or plans to work in a competitive field with KC180Fitness LLC.
By purchasing anything in the Store, I agree that I have read and agree to the Informed Consent and Privacy Act Forms, and Waiver of Liability statement.
