Name

First Name

Last Name

Phone

(###)

###

####

Which of the SMASH team are you working with?

Sam

Ash

1) My Commitment To You

a) Confidentiality. All information you give me will be kept in confidence. Your personal details and medical information will not be made available to third parties unless permission to do so is granted by you. b) Recommendations. Using my judgment and experience, I will suggest certain exercises and/or lifestyle advice that I believe will help you achieve your personal goals, but if at any time you have specific requests please tell me so I can accommodate them. c) Referral. I intend to work with you within the scope of my knowledge and competencies as a CIMSPA Registered Professional. Therefore when I believe it is in your best interests to see another health professional, I will make appropriate suggestions. d) If I (the trainer) cancels or runs late. Unforeseen circumstances may arise which require our sessions to be rescheduled. In this event the following policy will apply: • If I am forced to cancel our session within 12 hours I will make up the session at no charge to you. • If I am forced to cancel our session giving you more than 12 hours’ notice I will reschedule as soon as possible. • If I run late in starting our session I will extend the session time accordingly or make it up at a future date, whichever is most convenient to you.

2) Your Responsibilities To Me

a) Disclosure of information. Please disclose all health information as requested at our initial consultation and keep me updated and informed of any changes to your health status. This includes medical conditions; physical and mental, injuries, allergies, and medication you are taking. If necessary, you may need to seek clearance from your doctor before participation in any exercise programme(s) I may recommend. b) Accepting potential risks (fitness based sessions). Whilst for most people exercise is hugely positive with many health benefits, there remains some risk that I require you to be aware of and for you to sign the informed consent and disclaimer that I will provide. c) If you (the client) cancel or run late. • If you cancel your session with less than 12 hours’ notice, or fail to show you will be required to pay 100% of the session fee or lose one of your pre-paid sessions unless agreed otherwise in advance. • If you (the client) are late to a session, I will do my best to get the most out of the remaining time left in the session unless I am able to accommodate a longer running time. • In the case of group sessions, the session may still go ahead if all members of the group are not able to attend, however the full session price will still be charged. d) Other terms. PLEASE NOTE: In the event that you need to reschedule or you are running late for a session, please contact me ASAP by WhatsApp or Text message

2a) I have agreed the charge per session with my trainer:

Tick agreed session length

30 minutes

45 minutes

Other

2b) I agree to pay my trainer in advance of my sessions:

Tick agreed payment plan

Per single session

Per month

For a block of 10 sessions

Other

3) Communication and Commitment

While I can give you the tools and encouragement to reach your goals, ultimately you will need to assume responsibility for making the required changes. I can best help you with this process if you keep me fully informed of any issues that arise for you and if you have any questions or concerns whatsoever please don’t hesitate to voice them with me. Terms of this agreement The client understands that they are paying the trainer for their services as outlined in this agreement. In the event that the client doesn’t use the services, the client will still be responsible to make payment for the full initial term as agreed above. The trainer will deliver their sessions and advice to the best of their ability, will be registered with CIMSPA, and will respect all applicable UK laws and the CIMSPA Code of Conduct at all times. The client agrees to make all payments by the due date. Your trainer will provide their bank transfer details separately.

I have read and agree with the terms above

Signed

Check box below

I agree

Date

YYYY

Let’s work together!

Thank You!