Fitness centers offer customers electronic fitness waivers.

Client Intake Form

Please enter your full name.
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How do you rate your current fitness level (1-10): 

Do you currently workout? 

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How many days a week will you commit to this goal?

Time frame for achieving this goal?

Do you have any medical conditions we need to know about? (High Blood Pressure, Heart Condition, Diabetes, Seizures, Previous Injury)

I (the “Client”) voluntarily desire to participate in physical exercise training classes conducted on behalf of

Strength Camp Austin, and Strength Camp Pflugerville (the “Gym”) located at 13630 Immanuel Blvd, Pflugerville, TX 78660 and understand and agree to the following:

1. Client agrees to assume full responsibility while voluntarily participating in training at the Gym
at the Client’s sole risk and discretion. Client shall abide by any rules and regulations for use
of the Gym which may be communicated from time to time by the Gym.

2. Client understands and agrees that there is a risk of injury associated with participation in any
exercise program and that there exists the possibility for certain conditions occurring during or
following training. These may include, but are not limited to, abnormalities in blood pressure or
heart rate, heart attack or stroke, fainting or light headedness. The reaction of the cardiovascular system to such activity cannot be predicted.

3. It is strongly that the Client receives medical clearance from his/her physician prior to
participating in an exercise training class/program. The Gym’s training programs are not
designed for anyone who experiences any of the above conditions.

4. Client has been informed that any fitness program includes possible risks and all exercises
shall be undertaken at Client’s sole risk and discretion. Client assumes full responsibility for
any and all damages, injuries or losses that may be sustained or incur, while on Gym’s premise.
Client hereby waives all claims against the Gym, the Building Facility, the Instructors,
Employees or any Staff. Client hereby agrees to indemnify, defend, hold harmless, release and
discharge the Gym from all claims, demands, injuries, damage, actions, causes of actions, and
from all acts of negligence.

5. Client gives permission for the free use of Client’s name and/or picture in any broadcast,
telecast or other promotion that occurs to promote and advertise the Gym. To the extent that
any provision of this release is determined to be unenforceable, Client understands that the
remainder of such provisions shall still be enforceable. Client further states that by signing
below in the section for adults, that Client is of lawful age and legally competent to sign this
release on Client’s own behalf; that Client understands the terms herein are contractual and not
a mere recital; and that Client has signed this release below of Client’s own free will.


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