Personalized Services Consultation Form

1. It is your responsibility to contact your personal trainer directly to cancel the appointment and reschedule.

2. 24 hours’ notice is required for cancellation of a session. You may be charged for your missed appointment.

**Please Note: All personalized services packages and gift certificates purchased must be completed within one year of the purchase date.

I understand, agree and accept that there are potential risks to physical activity, evaluation and testing. I will be working with and around exercise machines, exercise accessories, testing instruments and may be involved in testing protocols (e.g. step test) and could be exposed to some accidents. I will be participating in exercise activities such as running and weight training and could be exposed to significant injury. This could include straining or even tearing muscles, tendons, ligaments, or heart stress, heart attack, broken bones, stroke, death or other forms of pain and suffering even though care will be taken by myself and others to avoid such injury.  I will inform the instructor(s)/trainer (s) if there are any problems during these tests or activities. At any time, I may withdraw my consent and terminate my participation in the activities described above.  I hereby release and hold harmless the agents, officers and employees of YWCA Metro Vancouver and affiliated companies, from any liability with respect to me or my property arising out of or connected with my partaking of any programs and courses offered by YWCA Metro Vancouver. 

Please read carefully and check YES or NO.

If you answered YES to one or more of the questions about your medical condition, you should seek further information before becoming more physically active or engaging in a fitness appraisal and complete a ParMedx.

We advise you that if you are currently taking medication, have any physical ailment or are otherwise not in a physical condition suitable for the activity, it could be injurious to you. You should seek medical advice regarding these matters before participating in these programs. THIS DOCUMENT IS A RELEASE OF CLAIMS AND BY SIGNING IT YOU:

1.  Acknowledge that when performing exercise routines or engaging in similarly strenuous activity, you may suffer injury.

2.  Represent to YWCA Metro Vancouver that you are in good health and physical condition and are not disabled, taking medication or suffering from a condition that would prevent you from engaging in such activities or make it potentially dangerous or harmful for you to engage in such activities.  Any significant changes in health will be disclosed to YWCA Metro Vancouver.

3.  Acknowledge that YWCA Metro Vancouver may retain a copy of this form for records. 

4.  ASSUME THE RISK OF AND HOLD YWCA METRO VANCOUVER HARMLESS FROM ANY LIABILITY FOR ANY PHYSICAL OR OTHER INJURY OR HARM SUFFERED BY YOU DURING OR AS A CONSEQUENCE OF PARTICIPATING IN SUCH PROGRAMS OR PERFORMING SUCH EXERCISE ROUTINES OR ENGAGING IN SUCH OTHER STRENUOUS PHYSICAL ACTIVITY, AND AGREE THAT YWCA METRO VANCOUVER SHALL NOT HAVE ANY LIABILITY OR RESPONSIBILITY FOR ANY SUCH INJURY OR HARM.

I HAVE CAREFULLY READ, UNDERSTAND, AND AS AN INDUCEMENT TO YWCA METRO VANCOUVER TO ALLOW ME TO PARTICIPATE IN THE PROGRAMS, AGREE TO THE FOREGOING.