Schedule Appointment with Avenue X Fitness

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First Name *

Last Name *

Phone *

Your E-Mail Address *

Notes to Business (your address or any special notes about your order)

Item	Quantity	Total
Single Group Training Session		$35.00
Total: $35.00	Coupon:

I plan to do Small Group Personal Training at Avenue X Fitness at 1562 King Avenue.

I am fully aware of all of the risks involved while participating in the activities. I am solely responsible for determining and assessing my health; there are no medical conditions present. I do not suffer from any medical condition or disease that might in any way hinder or prevent me from fully participating in Small Group Personal Training I have fully disclosed all pertinent medical and physical conditions to Avenue X prior to signing this waiver.

In return for my participation, I release, discharge, and agree to hold Avenue X Fitness harmless, along with any trainer or individual providing services, from any and all liability that may arise. This release is a binding legal document. Avenue X Fitness will have the legal right to rely fully on all statements that I make in this release.

*Any returned auto-debit will incur a $25 late fee. If a cancelation does occur with the auto debit, the payment method must be updated within 3 days or the next month (and ongoing payments) will default to the current rate for Small Group Personal Training. 30-day notice required for cancelation.