Blackwood Health Consultants
_________________________________________________________________ CLIENT AGREEMENT This agreement is made between Blackwood Health Consultants and the undersigned Client regarding the provision of exercise, nutrition, and/or fitness training. 1. Cancellation / Refund; Once payment is received, the client has three days to cancel, however a 50% deposit of that payment will be lost. After that three-day period no refund will be returned. Initial______ 2. Fees. The client shall pay according to the package that they choose to purchase. Payment is due at the time of purchase and will be renewed on the 25 th of each month if the client so chooses to continue. Initial______ 3. Scheduling; Cancellations. Training sessions must be scheduled in advance. The Client only upon at least twenty-four hours notice prior to the scheduled training session permits cancellations, otherwise the client will be charged for the full amount of the session. Initial______ 4. Late or No Show Policy. The Client should be prepared to begin the training session at the scheduled time. The Client realizes that when traveling to the Client, BHC may possibly be late due to traffic or weather conditions. BHC reserves the right to cancel a training session if the Client does not show up within fifteen minutes of the scheduled start time for a session, but the Client will be responsible for paying the full fee for that session. Initial______ 5. Health Condition. The Client has had a physical examination with a physician or other medical care provider selected by the client, has discussed the results of that examination with that medical care provider, and has notified Yvonne Blackwood in writing of any advice or limitations made by that health care professional as to the Clients participation in exercise, nutrition, or fitness programs with BHC. The client agrees to notify in writing of any future changes in this advice of materials regarding fitness testing and exercise routines. The Client agrees to notify BHC immediately if the Client feels discomfort at any time during a fitness session, so that appropriate care can be obtained or alternative exercise can be recommended. Initial______ 6. Consent to Emergency Medical Treatment. The Client agrees to be responsible for the costs of any medical care required to treat the client in an emergency and hereby authorizes BHC to arrange for any medical treatment required for the Client if the following persons cannot be reached in an emergency at the following telephone number: Name: __________________________Phone: ____________________________

7. Assumption of Risk. The Client is aware that exercise and fitness programs include physical activities, which are potentially hazardous and involve risks including injury or death. The Client is voluntarily participating in these activities with knowledge of the danger involved, and herby agrees to accept any and all risks of injury or death, and verifies this statement by placing my initials here: _______________________ Initial______ 8. Release. As consideration for being permitted by BHC to participate in these activities and use their facilities, the Client hereby agrees that the Client, the Clients’ assignees, heirs, distributees, guardians, and legal representatives will not make a claim against or sue BHC for injury or damage resulting from the negligence or other acts, howsoever caused, as a result of my participation in these activities. The Client herby releases BHC from all actions, claims, or demands that the Client, the Clients’ assignees, heirs, distributes, guardians or legal representatives now have or may hereafter have for injury or damage resulting from the Clients participation in the activities. Initial______ 8. Attorneys’ Fees. If any litigation is commenced between the parties to this agreement, concerning this agreement, or the rights and duties of either in relation to this agreement, the party prevailing in the litigation shall be entitled, in addition to any other relief that may be granted in the litigation, to reasonable attorneys’ fees incurred in the litigation. Initial______ Blackwood Health Consultants Yvonne Blackwood __________________________________ Client _________________________

Date _______________ Date ________________ Complete the following if the Client is a minor: The undersigned warrants that he or she is the parent or guardian of the Client, had carefully read the foregoing agreement, and understands its contents, including the release of liability. The undersigned agrees to the terms of this agreement for himself or herself and on behalf of the client and warrants that the undersigned has full authority to enter into this agreement. Accordingly, the undersigned agrees to indemnify, defend, and hold harmless BFN from any liabilities, damages, attorneys’ fees, actions, suits, or claims arising from or related to the Clients participation in these activities. Parent or Guardian of the Client ___________________________

To top