MembershipRegistration

Your Info:

First Name:

Last Name:

Address:

Birth Date:

Phone:

E-Mail:

How did you hear about us?

I'm signing up for the:

Does anyone currently have any medical conditions that
would prevent them from participating in exercise?

If you answered "YES" please explain:

This release is entered into between the undersigned and Body Styles Fitness. The purpose
of Body Styles Fitness is to provide fitness and exercise instruction.

The undersigned hereby acknowledge that the following was explained to them and/or agrees
to the following:

1.        Acknowledge that Antwan Richardson (Body Styles) is not a physician and is not
trained in any way to provide medical diagnosis, medical treatment, psychotherapy, or any
other type of medical advice.

2.        Acknowledges that fitness training is another tool for teaching individuals
about                                                           themselves, but that Antwan Richardson (Body
Styles) does not guarantee neither good nor bad will occur nor guarantees the coaching
advice given will produce neither good nor bad results.

3.        Acknowledges that Antwan Richardson (Body Styles) may suggest exercise as part of
my fitness program/lifestyle management. I further understand that swimming, cycling (on and
off road), in-line skating, skiing, weight training, aerobic classes, martial arts, kick boxing, and
any other related sports are an extreme test of one’s mental and physical limits and carry with
it potential for damages or loss of property serious injury or death. That the undersigned
assumes the risk of participating in these types of events/activities, that they are fit, and have
a regular medical physician regarding any medical problems that might develop. The
undersigned expressly waive, release, discharge, and agree not to sue from any liability of
death, disability, personal injury, or action of any kind Body Styles Fitness training for the
undersigned in said sporting events and/or training for said sporting/fitness activities. Client
assumes the risk of participating in an exercise program and agrees that Antwan Richardson
(Body Styles) shall have no liability for any injury, illness or similar difficulty that Client may
suffer arising out of or connected with Client participation in Body Styles program.

4.        The undersigned agree that this is the full agreement between the parties, that Body
Styles Fitness nor anyone else has not verbally contradicted any of the terms of this release
and that the undersigned has entered into this agreement free and voluntarily without force or
coercion.

5.        Client has been advised to consult a physician before starting a training
program.

6.        Client understands that there is a NO REFUND POLICY, but may receive a
credit towards personal training or the following Boot Camp if unable to complete
the one that was originally joined. Body Styles must be notified 14 days prior to
cancellation of membership. If Body Styles is notified less than 14 business days of
due date, the upcoming charges will still apply. Boot Camp membership is available
only to clients whom agree to automatic billing and payment terms.

Initial the
boxes below:

Signature:

Date:

Please print this page for your records before continuing.

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Your registration WILL NOT be accepted until payment has been received.