Jolie Nutrition & Fitness
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Notes to Business
(your address or any special notes about your order)
Hot Yoga Class Drop In
I understand that I am voluntarily participating in Jolie Nutrition & Fitness. I take full responsibility for my personal health and welfare while participating in any and all services and activities provided through Jolie Nutrition & Fitness. I understand that I should consult with a physician prior to beginning an exercise program. I also understand that there exists the possibility that exercise may induce physical changes due to the stress exercise can have upon the body. They include abnormal blood pressure, irregular heartbeat, lightheadedness, musculoskeletal injuries and in very rare instances, a heart attack.
I do declare myself to be physically sound and suffering from no condition, impairment, disease, or other illness that would prevent my participation or use of exercise equipment. If I have any of the above, I may be subject to a physician order for clearance to participate. I hereby agree to expressly assume and accept any and all risks of injury or death of myself.
I give permission to Jolie Nutrition & Fitness to use my workplace or personal email as a means of communication with me.
I have read the above information and understand that I am voluntarily participating in Jolie Nutrition & Fitness. Any questions which may have occurred to me have been answered to my satisfaction.
In Regards to Nutrition Coaching Services:
1. The purpose of nutritional counselling is to improve the overall health, vitality and well-being of the body through nutritional education and the use of natural foods and non-medicinal nutritional supplements. Jolie Nutrition & Fitness/Jolie Ensign does not diagnose diseases, disorders or conditions.
2. Jolie Nutrition & Fitness/Jolie Ensign isnot a licensed Dietitians, Naturopathic Doctors or Medical Physicians.
3. As part of the Nutritional Coaching Services, I may be asked to provide information concerning my physical habits, medical history, moods, energy levels, likes and dislikes, lifestyle and diet. This information is collected to enable Jolie Nutrition & Fitness/Jolie Ensign to: (i) assess my knowledge of nutrition, (ii) education me about the benefits of sound nutritional practices and (iii) recommend dietary changes to improve my general health, vitality and overall well-being. Jolie Nutrition & Fitness, will hold this information in confidence and will not release or disclose this information to any other person, without my prior consent, except as required by applicable law.
4. If Jolie Nutrition & Fitness, suspects the existence of disease, disorder or condition, I will be informed of this suspicion. However, I acknowledge this is not a diagnosis or conclusion about the state of my health and that I am directed to promptly consult a licensed Physician or Naturopath about any suspected problems.
5. Should I request Jolie Nutrition & Fitness, to recommend dietary changes and/or nutritional supplements to enhance my body’s natural ability to resist and/or overcome a known disease, disorder or condition, it is my responsibility to disclose the nature of the disease, disorder or condition and all other relevant details to Jolie Nutrition & Fitness. If I have not previously consulted a licensed Physician or Naturopath about this disease, disorder or condition, I acknowledge that I am directed to promptly do so. I am not to alter or discontinue treatments prescribed by a licensed Naturopath, Physician or other licensed health professional without consulting the individual who prescribed the treatment.
6. In providing Nutrition Coaching Services to me, Jolie Nutrition & Fitness, is relying upon the truth, accuracy and completeness of all information I have provided to her. Any recommendations I follow for changes in diet, including the use of nutritional supplements, are entirely my responsibility.
7. Jolie Nutrition & Fitness, is in no way liable for my health or safety.
8. In consideration of my participation in Jolie Nutrition & Fitness, I hereby accept all risk to my health, including injury or death that may result from such participation and I hereby release Jolie Nutrition & Fitness, on my behalf and on behalf of my personal representatives, estate, heirs, next of kin, and assigns from any and all costs, claims, causes of action and damages arising from any and all illness or injury to my person, including my death, that may result from or occur as a result of my participation in Habit, whether caused by negligence or otherwise.
9. 2 hours is required for cancelling appointments. Appointments cancelled within 2 hours of your appointment time, you will be billed at 50%.
10. I understand that any therapies I undertake at Jolie Nutrition & Fitness are undertaken of my own free will. I accept that the ultimate responsibility for my health care is my own and that Habit is here to support me in this. I understand that my practitioner reserves the right to determine which cases fall outside their scope of practice, in which event an appropriate referral will be recommended. I hereby agree to assume full responsibility for any manner of loss, injury, claim or damage whatsoever, known or unknown, incurred as a result of same and I, my heirs, executors, administrators or assigns for any loss, injury, claim or damage sustained as a result of my attendance and/or participation. I have read the above release and waiver of liability, and fully understand its contents and voluntarily agree to the terms and conditions stated.
11. *As a policy we DO NOT give CREDIT CARD refunds for any reason.
I HAVE CAREFULLY READ THIS AGREEMENT AND AGREE TO THE TERMS OUTLINED ABOVE. I UNDERSTAND THIS AGREEMENT TO BE A FULL AND FINAL RELEASE OF ALL COSTS, CLAIMS, CAUSES OF ACTION AND DAMAGES OF ANY KIND ARISING FROM OR IN CONNECTION WITH Jolie Nutrition & Fitness Classes, Events, Workshops and/or Nutrition Coaching SERVICES.
You must agree to the terms above to continue