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THE SHIFT METHOD | FITNESS AND EDUCATION LLC

Informed Consent and Liability Waiver for Participation in an Exercise Program
General Statement of Program Objectives & Procedures:

I understand that this exercise program includes exercises to build the cardiorespiratory and
musculoskeletal system, and to improve body composition. Exercise may include aerobic activities (walking, running, jumping, and other aerobic activities), callisthenic exercises, and weightlifting.

Description of Potential Risks:
I understand that the reaction of the cardiorespiratory, and musculoskeletal system to exercise cannot always be predicted. I know there is a risk of certain abnormal changes occurring during or following exercise. Abnormal changes may include, but are not limited to, musculoskeletal injuries, abnormal blood
pressure, faintness/dizziness, heart rhythm disturbances, and in very rare instances, stroke, heart attack or even death. Every effort will be made to minimize these occurrences by proper assessment prior to training, appropriate supervision, and my own control of my exercise efforts. I understand that I am
responsible for monitoring my own condition throughout each exercise session, and should (if any unusual symptoms occur), immediately stop and notify my trainer. I understand my trainer will
periodically monitor my performance; heart rate, blood pressure, and/or feelings of exertion. I
understand the trainer / instructor may reduce or stop exercise when any of these findings indicate it is necessary for my safety. If medical clearance must be obtained prior to my participation, I agree to consult my physician and obtain written consent prior to the commencement of any exercise program.

In consideration for participating in this exercise program, I agree to assume the risk of such exercise and I further agree to hold harmless the trainer, and all affiliates from any and all claims, demands, damages,
rights of action, present and future that arise from my participation in the exercise program, including but not limited to claims that may result from injury or death.

Description of Potential Benefits:
I understand that a program of regular exercise for the cardiorespiratory and musculoskeletal system has many benefits associated with it. These may include: improved body composition, improved cardiorespiratory fitness, improved blood pressure and blood cholesterol levels, improved mental health, and decreased risk of chronic diseases.

Online Services:
I understand that if I participate in online services (virtual coaching / online program design) I must abide by the statements made above. If participating in online services, I understand that additional risks may be
present, such as not having my trainer with me while training. If training at another facility using online services, I understand that I am actively participating under the facility’s jurisdiction, not my trainer’s.

In signing this consent and liability waiver, I affirm that I have read this form in its entirety and
understand the nature of the exercise program. I also affirm that my questions regarding the program
have been answered to my satisfaction.

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