1. Intake Form 1. Intake Form 2. Medical Form 3. Photos Step 1 of 6 - Contact Information 16% To get started with Trench Fitness, please complete this Intake Form as your first step. If you are already a Trench Fitness client and are renewing your service(s), you do not have to fill in this intake form. Instead continue to the Renew page and follow the steps to purchase your renewal.Contact InformationName* First Last Email* Cell Phone*Home PhoneAddress Street Address Address Line 2 City AlbertaBritish ColumbiaManitobaNew BrunswickNewfoundland and LabradorNorthwest TerritoriesNova ScotiaNunavutOntarioPrince Edward IslandQuebecSaskatchewanYukon Province Postal Code Personal InformationAge*Height Current Weight (in the morning after you you use the washroom, before you eat)Gender* Female Male Occupation How Did You Hear About Us? Family/Friend Facebook Instagram YouTube Web Search Who Referred You To Us? Goals & HistoryYour GoalsGoals you are looking to achieve/the reason why you contacted Trench Fitness Motivation LevelExcellentPretty goodNeutralNot so greatTerribleScale of 1-5 with 5 being the most motivated Medical HistoryCurrent Nutrition/DietFood You Enjoy EatingAllergiesCurrent Exercise RoutineDays to Weight TrainHow many days per week would you like to weight train? 1 Day 2 Days 3 Days 4 Days 5 Days 6 Days 7 Days Injuries Electronic CommunicationsElectronic Communications ConsentPlease consent to receive electronic messages from Trench Fitness which may include announcements, invitations, event information, news, updates, service information, client customer care, and promotions from us. You can unsubscribe at any time. I Do Not Consent I Consent Trench Fitness Email NewsletterTrench Fitness Email Newsletter SubscriptionWe send out a helpful newsletter with the latest Trench Fitness News, Workout Tips, and Recipes approximately 4 times a year. You can unsubscribe at any time. Yes I would like to Subscribe Fitness Services AgreementTrench Fitness Inc. 115 Hodsman Road, Regina, SK S4N 5W5 This Fitness Service Agreement and Release of Liability (the "Agreement") is between you and Trench Fitness Inc. ("Trench Fitness"). You hereby agree that you are purchasing from Trench Fitness for your benefit, fitness services according to the terms of this Agreement. Services Purchased: As listed on your order confirmation. Notice: You are entitled to a copy of this Agreement. Term Acknowledgement: The term of this Agreement is for: Personal Training – One year from first use or until the total number of Sessions are used, whichever comes first Group Training – Until the total number of Classes are used or 25 Days from first use for 10 Class packages or 112 Days from first use for 24 Class packages, whichever comes first. Nutrition & Exercise Consulting – 12 Weeks Contest Prep – 12 Weeks Payment: All prices are in Canadian funds. By signing this Agreement, you acknowledge that you have read, understood and agreed with all terms and conditions of this Agreement, after having the opportunity to have it reviewed by a lawyer at your sole discretion. You further acknowledge that you are entitled to receiving a completed copy of this agreement, which includes the EFT Credit Card & Authorization, Acknowledgement & Assumption of Risk, Limitation of Liability & Full Release of Trench Fitness. This constitutes the entire agreement of the parties and no other agreement or understanding exists between you and Trench Fitness. Trench Fitness has made no express or implied warranties or representations other than those expressly set forth in this Agreement to induce you to enter into this Agreement. Any conflict between the original Agreement and any copy of the original Agreement shall be controlled by the original Agreement. This agreement is fully assignable by Trench Fitness but is not transferable or assignable by you. You may cancel this agreement at any time during the period that ends 7 business days after the later of the day you receive a written copy of the agreement and the day all the services are available. You do not need to give Trench Fitness a reason for canceling during this period. In addition, there are other grounds that allow you to cancel this agreement. You may also have other rights, duties and remedies at law. For more information, you may contact the Consumer Protection Branch, Saskatchewan Justice. To cancel this agreement, you must give a signed and dated notice of cancellation to Trench Fitness, at the address set out in the agreement, by personal service, by registered mail or by any other means as set out in the agreement. If you cancel this agreement, Trench Fitness has 15 days to provide a refund to you (less an amount of any services used or in the case of services sold as a package a pro-rated amount for any services used) in accordance with the Act. If Nutrition & Exercise Consulting or Contest Prep is selected above, for the purposes of calculating the refund for any services used, a consultant will start working on your customized plan starting on Today’s Date - the plan customization has a $200 value and if you have met with a consultant it is valued at $75. Notice: All notices to Trench Fitness shall be mailed to (certified or registered, return receipt requested) to 115 Hodsman Road, Regina, SK S4N 5W5. Fitness/Consulting Services: The fitness or consulting services provided under this Agreement, if applicable, are provided as a program by Trench Fitness, and are not the services of any individual trainer. The assigned trainer may not be available to conduct all sessions, in which case another trainer will be assigned. You are not entitled to a refund if the originally assigned trainer is not available. Trench Fitness will use its best efforts to provide the best service possible to accommodate your requests for a specific trainer of your preferred gender, age, appointment time, etc., but will not be held liable or in breach of this Agreement in the event these requests cannot be met. Trench Fitness also reserves the right to sell training, class packages, and memberships at different rates or terms than set forth in this Agreement. I understand results are not guaranteed and are dependent on several factors including my adherence to the diet and exercise program as recommended, if applicable. I understand that results of the programs offered will vary from person to person and are neither predictable nor controllable by Trench Fitness or any of its agents or employees. Trench Fitness or any of it agents or employees are not licensed dietitians or nutritional specialists. All information I obtain will be directly from the consultant's own experiences. Training packages expire 1 year after first use. Group Training Class packages expire 35 days from first use for 10 Classes or 112 days from first use for 24 Classes. Appointment and Cancellations: Cancellation of any scheduled appointment for a Trench Fitness service must be made at least 24 hours prior to the scheduled appointment time. If notice of cancellation is not provided within 24 hours of the scheduled appointment time, the appointment will be considered a “no-show” and you will be charged for the session or class In the unlikely event that your trainer “no-shows”, for the scheduled appointment or class and there is no other trainer available at that time, Trench Fitness will credit you one free session. If a class is cancelled, Trench Fitness will credit you one free session. Facilities, Services and Hours: Trench Fitness services and amenities may be improved, updated, modified, or otherwise altered at the sole and absolute discretion of Trench Fitness. Trench Fitness will strive to provide the best service possible and accommodate reasonable requests, but reserves the right, in its sole and absolute discretion, to change the existing services, training or class schedules, programs, hour of operation, days the facility is open, and rules and regulations. If you do not purchase a General Gym Access Membership, you do not have the right to use the facility or equipment unless under the direct supervision and instruction of a trainer as part of your scheduled Personal Training or Group Training service. Payments and Refund Policy: Payment for Memberships, training sessions, classes, consulting or any other services must be made in full unless otherwise agreed upon in writing. No refunds shall be made for any memberships, personal training, classes, or consulting services purchased, except as specifically provided in this Agreement. Medical Advice Not Provided: You hereby acknowledge that Trench Fitness does not diagnose health problems, and does not provide medical advice nor medical services. Trench Fitness has advised you to discuss the appropriateness of your exercise program with your doctor. Trench Fitness may ask you to fill out a Health Questionnaire, but this document is nothing more than guidance for Trench Fitness to review or to help you set your fitness goals. The fact that Trench Fitness agrees to provide the services discussed herein to you based on the questionnaire and your representations is not a medical judgement that you are medically, physically, or mentally able to enjoy the benefits of Trench Fitness’s services. Our services should not replace any dietary restrictions or medical recommendations from your doctor. I hereby affirm that I am in good physical condition and do not suffer from any disability that would prevent or limit my participation in a training activity or use of the facility. Use of Images and Testimonials: You hereby grant Trench Fitness the right to use your pictures (still or moving), statements and comments, in part or in whole, in any media, to promote Trench Fitness or the products and services of Trench Fitness. Privacy Policy: Any credit card/personal information is securely stored on Trench Fitness’s servers and will not be sold to any third parties. If you consented to receive electronic messages from Trench Fitness they may include announcements, invitations, event information, news, updates, service information, client customer care, and promotions from us. You can unsubscribe at any time. Default: You shall be deemed in default of this Agreement upon the failure to comply with any of the terms and conditions of this Agreement, including, but not limited to, the obligation to make any payment as and when due. You also agree to be bound by the Trench Fitness Rules & Regulations provided herewith, and acknowledge that a violation of such Rules and Regulations shall constitute a default event. Upon default, Trench Fitness shall have all rights and remedies available, including termination of this Agreement and institution of an action for all applicable damages. If Trench Fitness delays or refrains from exercising any rights under this Agreement, Trench Fitness does not waive and shall not forfeit those rights. If Trench Fitness accepts late or partial payments from you, Trench Fitness does not waive its right to receive full and timely payments and other charges due under this Agreement. Enforceability: The parties hereto agree that if any provision or portion of this Agreement is declared void and unenforceable, such provision or portion of a provision shall be deemed severed from this Agreement, which shall otherwise remain in full force and effect. However, you specifically agree that all the terms and conditions are to be enforced and you specifically waive any statute or other right, of any type, which would invalidate the enforceability of any provision or portion of a provision of this Agreement. Governing Law: This Agreement shall be governed and enforced in accordance with Saskatchewan Law. Acknowledgement & Assumption of Risk: You hereby acknowledge that the services purchased under this Agreement include participation in strenuous, high-intensity physical activities, including, but not limited to weightlifting, walking, running, jumping, pushing, pulling, climbing, plyometrics, carrying relatively heavy objects, and the use of various conditioning and exercise equipment and facilities designed, offered, recommended and/or supervised by Trench Fitness or any of its agents or employees. You acknowledge that these physical activities involve the inherent risk of physical injuries or other damages, including, but not limited to, heart attacks, death, muscle strains, pulls or tears, broken bones, shin splints, heat prostration, foot/knee/hip/back injuries and any other illnesses, soreness, or injury however caused occurring during or after your participation in physical activities at Trench Fitness. You further acknowledge that such risks include, but are not limited to, injuries caused by the negligence of an instructor or other person, defective or improperly used equipment, or your own over-exertion, slip and fall, or unknown health problem. You specifically acknowledge and assume the risk of injury due to Rhabdomyolysis and/or other exertion related injuries and illnesses, and hereby accept that it is your responsibility to recognize your limits and stop all physical activities when you believe it is necessary to do so. You agree to assume all risks and responsibilities involved with your participation in physical activities at Trench Fitness. You acknowledge your participation will be physically and mentally challenging, and you agree that it is your responsibility to seek competent medical or other professional advice regarding any concerns or questions involved with your ability to take part in physical activities at Trench Fitness. By signing this Agreement, you assert that you are capable of participating in physical activities at Trench Fitness, and that you agree to assume all risk and responsibility for exceeding your physical limits. Limitation of Liability & Full Release of Trench Fitness: You, your heirs, assigns and next of kin, agree to fully release Trench Fitness, its owners, employees, any related entities or other authorized agents, including independent contractors from any and all liability, claims and/or litigation or other actions that you may have for arising from my participation in a training session or class or from any use of the exercise equipment and facilities from injuries, disability, death or other damages of any kind, including, but not limited to, direct, special, incidental, indirect, punitive, or consequential damages, whether arising in tort, contract, breach of warranty or arising out of participation in physical activities at Trench Fitness even if caused by the negligence or fault of Trench Fitness, its owners, employees, or related entities or other authorized agents, including independent contractors. I fully understand that I may suffer injury and I hereby release Trench Fitness, and any of its agents or employees from any and all liability now or in the future, including but not limited to: medical expenses, lost wages, pain and suffering that may occur by reason of heart attacks, muscle strains, pulls or tears, broken bones, shin splints, heat prostration, knee/lower back/foot injuries, and any other illnesses, soreness, or injury, however caused, whether occurring during or after my participation in the program or use of the conditioning and exercise equipment and facilities, regardless of fault. I understand and agree that any injuries or illnesses that might occur during my own training (without the supervision of Trench Fitness, or any of its agents or employees) is my own dilemma. Additionally I am responsible for my own health and safety. You are urged to have this Agreement reviewed by a lawyer before signing. I acknowledge that this agreement including the Limitation of Liability & Full Release is valid indefinitely.Do you Agree to the Above Statement?* Yes, I Agree Electronic Signature* Please type your full first and last name above. This is considered to be your electronic signature of this Agreement. In addition by attending a Trench Fitness training session or using advice provided by a Trench Fitness consultant further constitutes your consent to this Agreement.Today's Date MM slash DD slash YYYY ServicesWhat Services are you Interested in? Nutrition & Exercise Consulting Plan Personal Training Group Strength Training Contest Prep What is your availability like?Describe your general availability for personal training session days and time ranges.NameThis field is for validation purposes and should be left unchanged.
