Signup for online coaching Step 1 of 4 25% Name* First Last Birthdate* Date Format: MM slash DD slash YYYY Gender*MaleFemaleEmail Phone*FacebookInstagram nameList current physical activites*What is your activity level?*Very ActiveActiveModerately ActiveSedentaryCurrent weight (pounds)*Current waist measurement (inches)Do you have a gym membership or home gym*YesNoFront body pictureBack body pictureOnline Coach PreferenceJessicaMikeMarissaStefanieMitchell Medical HistoryAny injuries?YesNoPlease explain injuriesHistory of heart problems?YesNoAny chronic illness or conditions?YesNoCleared from a physician?YesNoPregnancy (now or within the last 3 months)?YesNoBreathing or lung problems?YesNoDiabetes?YesNoIncreased blood pressure or high cholesterol?YesNoOn any medications?YesNoPlease specify medications:Do you currently have a heart rate monitor?YesNoFitbit?YesNoUse MyFitnessPal or some other food logging app?YesNoHave you worked with an online personal trainer in the past?YesNoWhat Are Your Personal Goals?Short term goals?Long term goals? Current Exercise RegimenPlease select ANY exercises that you currently participate in. Or, if you currently aren't doing any exercise but have worked out consistently in the past 3-4 months, indicate what you were doing.Mark which information you are providing:Current routinePast routine (within 3-4 months)Cardiovascular Training Walk Jog Swim Step or Hi/Lo Aerobics Kickbox Other Check applicableWalk FrequencyWalk Session LengthWalk Average Pace 1-2 X per week3-4 X per weekMore than 4 X per weekLess than 30 minutes30-45 minutesmore than 45 minutes Jog FrequencyJog Session LengthJog Average Pace 1-2 X per week3-4 X per weekMore than 4 X per weekLess than 30 minutes30-45 minutesmore than 45 minutes Swim FrequencySwim Session Length 1-2 X per week3-4 X per weekMore than 4 X per weekLess than 30 minutes30-45 minutesmore than 45 minutes Aerobics FrequencyAerobics Session Length 1-2 X per week3-4 X per weekMore than 4 X per weekLess than 30 minutes30-45 minutesmore than 45 minutes Kickbox FrequencyKickbox Session Length 1-2 X per week3-4 X per weekMore than 4 X per weekLess than 30 minutes30-45 minutesmore than 45 minutes Type of ActivityOther FrequencyOther Session Length 1-2 X per week3-4 X per weekMore than 4 X per weekLess than 30 minutes30-45 minutesmore than 45 minutes Strength Training Dumbbells Weight Machines Check applicableDumbells FrequencyAverage Weight Size 1-2 X per week3-4 X per weekMore than 4 X per week0-3 pounds4-5 pounds6-9 pounds10-15 pounds16-20 pounds21+ pounds Weight Machines FrequencyAverage Weight Size 1-2 X per week3-4 X per weekMore than 4 X per week0-10 pounds10-15 pounds16-20 pounds21-30 pounds31-40 pounds41-50 pounds51-60 pounds61-70 pounds71-80 pounds81+ pounds Mind/Body Yoga Pilates Check applicableYoga FrequencyYoga Session Length 1-2 X per week3-4 X per weekMore than 4 X per weekLess than 30 minutes30-45 minutesmore than 45 minutes Pilates FrequencyPilates Session Length 1-2 X per week3-4 X per weekMore than 4 X per weekLess than 30 minutes30-45 minutesmore than 45 minutes Fitness EquipmentSelect ALL equipment that you either own or have access to Treadmill Resistance Band Exercise Stability Ball Elliptical Bosu Home gym Access to fitness clib Dumbbells Step for Step Aerobics Jump Rope Bike Weighted Bar Bar Bell Other equipment Liability Release Agreement (Individual)Please read this agreement ("Agreement") carefully before accessing or using the Web sites at Perfection Fitness Online Coaching and its affiliated sites (the "Sites"). By accessing or using the Sites, or by choosing "Yes" in the selection below, you agree to be bound by this Agreement. We provide the information and services on these Sites to you, the user, conditioned on your acceptance without modification of the terms, conditions and notices contained herein. Your use of the Sites constitutes your agreement to all such terms, conditions and notices. Liability Release Agreement (Individual) I hereby accept all risks associated with Perfection Fitness Online Coaching program and release and forever discharge Perfection Fitness, LLC and its respective heirs, directors, officers, agents, employees, representatives, successors and assigns, administrators, executors, and all others ("RELEASEES") from any and all responsibilities or liability from injuries or damages resulting from or connected with my participation in any of the Perfection Fitness Online Coaching exercise programs whether arising from the negligence of the RELEASEES or otherwise. 1. I acknowledge and fully understand that I will be engaging in training activities that potentially involve the risk of serious injury or possibly permanent disability and death, and severe social and economic losses which might result not only from their own actions, inactions, or negligence, but the actions, inactions, or negligence of others, the condition of the premises or any equipment. Further, that there may be other risks not known or not reasonably foreseeable at this time. 2. I further acknowledge and understand that Perfection Fitness Online Coaching and its employees are not licensed dieticians and that any nutritional information or guidelines provided by Perfection Fitness Online Coaching carries no warranty of any kind, express or implied, including but not limited to warranties regarding safety or suitability for a particular purpose. 3. I hereby assume full responsibility for all the foregoing risks, known and unknown, and accept responsibility for the damages following any injury, permanent disability, or death. 4. I shall indemnify and hold Releasees harmless from any and all claims (including reasonable defense costs and attorneys’ fees) arising out of any bodily injury or death of any person, or damage to any property, to the extent caused by my negligence or willful misconduct. 5. I acknowledge and understand that insurance coverage maintained by Perfection Fitness Online Coaching is excess coverage and begins after the exhaustion by me of all other insurance coverage for which I may be eligible, including but not limited to exhaustion of all insurance coverage provided by my personal trainer or his/her company and/or workout facility. 6. I hereby consent to allow my name, image, likeness and/or voice to appear in publications, official documentaries, promotional materials, and advertisements, and any and all television, radio or film coverage of Perfection Fitness Online Coaching in any manner incidental to my participation in the exercise program, without compensation. This waiver and release agreement specifically embraces each and every event, activity or purchase sanctioned by said RELEASEES, and has the same effect as if executed after each and every sanctioned event, activity or purchase in which I participate so that the parties herein intended to be released shall be fully and effectively released as to each and every sanctioned event, activity or purchase. Perfection Fitness Online Coaching cannot guarantee that its products or workouts will be safe, effective or suitable for everyone. For that reason, all such products and services, and the programs, techniques and materials embodied in such products and services, are offered without warranties or guarantees of any kind, express or implied, and Perfection Fitness Online Coaching disclaims any liability, loss or damages that may result from their use. Perfection Fitness Online Coaching is owned and operated by Perfection Fitness, LLC.Do you agree to the release of liability terms detailed above?Yes: By choosing Yes you are indicating that you have read the Release of Liability above, fully understand and accept its terms and that you have given up substantial rights by accepting these terms.NoPURCHASE AGREEMENTMONTHLY fees are not refundable. Online Services are not transferable and only you are authorized to use this service. Only registered Perfection Fitness Online Coaching online clients have permission to view and print any and all of the information provided within the Perfection Fitness Online Coaching website. Online clients, or anyone otherwise, may not loan, rent, lease, or otherwise transfer the information to another person without the written permission of Perfection Fitness Online Coaching. You may cancel your online services at any time (but no refund will be provided on programs already purchased). Your service will automatically renew until Perfection Fitness Online Coaching receives cancellation notice from you. Automatic renewal dates are based on the date that you provide payment. Perfection Fitness Online Coaching reserves the right to deny services to anyone. TERMS OF USE AGREEMENT BETWEEN USER AND WORKOUTS FOR YOU TERMS OF USE Please read this agreement ("Agreement") carefully before accessing or using the Perfection Fitness Websites at www.perfectionfitness.com and its affiliated sites (the "Sites"). By accessing or using the Sites, You agree to be bound by this Agreement. Perfection Fitness, LLC d/b/a Perfection Fitness Online Coaching ("Perfection Fitness Online Coaching" or "We") provides the information and services on these Sites to you, the user, conditioned on your acceptance without modification of the terms, conditions and notices contained herein. Your use of the Sites constitutes your agreement to all such terms, conditions and notices. These Terms and Conditions of use apply to information you have received on the Sites in the past. The information and services offered on the Sites are provided with the understanding that neither Perfection Fitness Online Coaching nor its representatives are engaged in rendering legal services or other such advice. Your use of the Sites is subject to the additional disclaimers and notices that may appear throughout the Sites and to the terms and conditions of the Perfection Fitness Online Coaching Limitation of Liability Agreement (Individual) discussed below. Perfection Fitness Online Coaching and its representatives assume no responsibility for any consequence relating directly or indirectly to any action or inaction that you take based on the information, services or other material on these Sites. While Perfection Fitness Online Coaching strives to keep the information on these Sites accurate, complete and up-to-date, Perfection Fitness Online Coaching and its representatives cannot guarantee, and will not be responsible for any damage or loss related to, the accuracy, completeness or timeliness of the information. These Sites and the information and services we provide may not be used by children under the age of 16. Perfection Fitness Online Coaching may decline to provide you services in our sole discretion. PRIVACY POLICY At Perfection Fitness Online Coaching ("Perfection Fitness Online Coaching " or "We"), user privacy is an important concern. We are committed privacy and security, and to providing the best possible user experience for our users and online customers ("You"). We also strive to protect the personal and confidential information of those who use our on-line services. Please read our entire Privacy Policy. This policy may be updated by us from time to time, so please check here frequently. LIABILITY RELEASE AGREEMENT The services provided by Perfection Fitness Online Coaching may involve certain risks to participants. You also agree to our Liability Release Agreement. You hereby agree to all terms, conditions and notices contained in that agreement. PERSONAL AND NONCOMMERCIAL USE LIMITATION: PROHIBITED USES We may provide online personal training services (the "Services"). Perfection Fitness Online Coaching grants You access to the Sites during the term of this agreement solely to receive the Services and related information on the Sites. You may access, download print, copy and distribute and modify materials as necessary to receive the Services. You may not license, create derivative works from, frame in another Web page, use on any other Web site, or sell any information, databases or lists obtained from the Sites. When requested, you agree to provide true, accurate and complete user information. You shall not access or attempt to access password protected, secure or non-public areas of the Web Sites without our prior written permission You will comply with all privacy laws. You may not engage in the practices of screen scraping, data mining or any other bulk information gathering in connection with the Web Sites. PROPRIETARY RIGHTS All materials on these Sites (as well as the organization and layout of the Sites) are owned and copyrighted, licensed by, or used with permission that is granted to Perfection Fitness Online Coaching. No reproduction, distribution, or transmission of the copyrighted materials at these Sites is permitted without the prior written permission of Perfection Fitness Online Coaching. NO UNLAWFUL OR PROHIBITED USE As a condition of your use of these Sites, you warrant to Perfection Fitness Online Coaching that you will not use these Sites for any purpose that is unlawful or prohibited by these terms. If you violate any of these terms, your permission to use the Sites automatically terminates. You may not, without the prior written permission of Perfection Fitness Online Coaching, use any computer code, data mining software, "robot," "bot," "spider," "scraper" or other automatic device, or program, algorithm or methodology having similar processes or functionality, or any manual process, to monitor or copy any of the Web pages, data or content found on these Sites or accessed through these Sites. DISCLAIMER OF WARRANTIES YOU EXPRESSLY UNDERSTAND AND AGREE THAT YOUR USE OF THESE SITES AND THE SERVICES OFFERED AT THE SITES IS AT YOUR SOLE RISK. THE SITES ARE PROVIDED ON AN "AS IS" AND "AS AVAILABLE" BASIS. WORKOUTS FOR YOU EXPRESSLY DISCLAIMS ALL WARRANTIES OF ANY KIND, WHETHER EXPRESS OR IMPLIED, INCLUDING, BUT NOT LIMITED TO THE IMPLIED WARRANTIES OF MERCHANTABILITY, FITNESS FOR A PARTICULAR PURPOSE AND NON-INFRINGEMENT. ANY MATERIAL DOWNLOADED OR OTHERWISE OBTAINED THROUGH THE USE OF THE SITES IS DONE AT YOUR OWN DISCRETION AND RISK AND THAT YOU WILL BE SOLELY RESPONSIBLE FOR ANY DAMAGE TO YOUR COMPUTER SYSTEM OR LOSS OF DATA THAT RESULTS FROM THE DOWNLOAD OF ANY SUCH MATERIAL. LIMITATION OF LIABILITY YOU EXPRESSLY UNDERSTAND AND AGREE THAT PERFECTION FITNESS ONLINE COACHING SHALL NOT BE LIABLE FOR ANY DIRECT, INDIRECT, INCIDENTAL, SPECIAL, CONSEQUENTIAL OR EXEMPLARY DAMAGES, INCLUDING BUT NOT LIMITED TO, DAMAGES FOR LOSS OF PROFITS, GOODWILL, USE, DATA OR OTHER INTANGIBLE LOSSES (EVEN IF ADVISED OF THE POSSIBILITY OF SUCH DAMAGES), RESULTING FROM: (i) THE USE OR THE INABILITY TO USE THE SITE OR SERVICES; (ii) THE COST OF PROCUREMENT OF SUBSTITUTE SERVICES RESULTING FROM ANY DATA, INFORMATION OR SERVICES OBTAINED OR MESSAGES RECEIVED OR TRANSACTIONS ENTERED INTO ON THE SITE OR THROUGH OR FROM THE SERVICE; (iii) UNAUTHORIZED ACCESS TO OR ALTERATION OF YOUR TRANSMISSIONS OR DATA; (iv) STATEMENTS OR CONDUCT OF ANY THIRD PARTY ON THE SERVICE; OR (v) ANY OTHER MATTER RELATING TO THE SITES OR THE SERVICES. LINKS TO THIRD PARTY SITES These Sites may contain hyperlinks to web sites operated by parties other than Perfection Fitness Online Coaching or its affiliates. Such hyperlinks are provided for your reference only. Perfection Fitness Online Coaching does not control such web sites, and is not responsible for their content. Inclusion of hyperlinks by Perfection Fitness Online Coaching to such web sites does not imply any endorsement of the material on such web sites or any association with their operators, and your access to and use of such sites, including information, material, products and services therein, is solely at your own risk. Furthermore, because the Perfection Fitness Online Coaching privacy policy is applicable only when you are on our Site, once linked to another web site, you should read that site’s privacy policy before disclosing any personal information. USE OF SUBMISSIONS You grant us the right to use, reproduce, modify, distribute, and display any material, including your testimonials, that you supply or communicate to the Sites for any purpose related to the Sites and the performance of the Services. CHANGES TO SITES Perfection Fitness Online Coaching may make improvements or changes in the information, services, products, and other materials on these Sites, or terminate these Sites at any time. Perfection Fitness Online Coaching may modify this Agreement at any time, and such modifications shall be effective immediately upon posting of the modified Agreement. Accordingly, you agree to review the Agreement periodically, and your continued access or use of these Sites shall be deemed your acceptance of the modified Agreement. MISCELLANEOUS This Agreement and the resolution of any dispute related to this Agreement or these Sites shall be governed by and construed in accordance with the laws of California, without giving effect to any principles of conflicts of law. Failure by Perfection Fitness Online Coaching to insist upon strict enforcement of any provision of this Agreement shall not be construed as a waiver of any provision or right. You agree that regardless of any statute or law to the contrary, any claim or cause of action arising out of or related to use of these Site or this Agreement must be filed within one (1) year after such claim or cause of action arose or be forever barred. Any legal action or proceeding between Perfection Fitness Online Coaching and you related to this Agreement shall be brought exclusively in a federal or state court of competent jurisdiction sitting in the State of California, County of San Bernardino. If any of these terms shall be deemed invalid, void, or for any reason unenforceable, that term shall be deemed severable and shall not affect the validity and enforceability of any remaining term. Perfection Fitness Online Coaching and other logos, product and service names are trademarks and service marks owned by or licensed to Perfection Fitness Online Coaching or its affiliates (the "Marks"). Without the prior written permission of Perfection Fitness Online Coaching, or its appropriate affiliates, you agree not to display or use in any manner, the Marks. Do you agree to the membership agreement and terms of use detailed above?Yes: By choosing Yes you are indicating that you have read the Membership Agreement and Terms of Use above and fully understand and accept its terms.No