Health Questionaire/ Intake Form

    Commitment Levels

    Health History

    In order for us to know you better and design a fitness program that is best for you, please provide the following health history information.  All information is strictly confidential

    Waiver and Release form

    Member’s Obligation. Member shall not be relieved of the obligation to make payments agreed to, and no deduction from any payment shall be made because of Member’s failure to use the membership, individual class, session or package of the Club. Payments are for the services and/or period, and at the rate as agreed to in contract. Form of Payment. All payments (including monthly dues and/or per class payments and incidentals) are payable by electronic funds transfer from the Member’s credit card account or debit card account. Member must authorize payments to be made through a third party administered electronic funds transfer system. In the case of membership packages, transfer of fees will take place automatically once every month.
    Returned Payment Penalty. Member will automatically be charged any bank fee imposed on AB Fitness & Nutrition Inc, plus a processing fee of up to $25, for any returned payment item due to closed accounts, insufficient funds or similar issue. On such occasion, AB Fitness & Nutrition Inc retains the right to collect the current and past due balances in any subsequent month.Revocation of Membership. AB Fitness & Nutrition Inc, (in its sole discretion) may revoke Member’s membership and/or session/class credits, at any time and without refund, in the event that Member engages in behavior that is unsafe or objectionable to other members or staff, or for reasons of nuisance, disturbance to other members or staff, moral turpitude or fraud, or personal hygiene and attire. AB Fitness & Nutrition Inc also reserves the right to require Member to leave for the day if, in AB Fitness & Nutrition Inc reasonable judgment, Member poses a health or safety risk to Member or others or is disturbing or likely to disturb other members or staff.
    Medical Recommendations. Member should consult with his/her physician or have a physical examination before using any of the AB Fitness & Nutrition Inc’s facilities or enrolling in any of the AB Fitness & Nutrition Inc’s classes or sessions especially if Member is elderly, pregnant, has a history of heart disease, high blood pressure or other chronic illness, or is unaccustomed to physical exertion or has other physical limitations.Activity Risk. Any strenuous athletic or physical activity involves certain risks. Member and his or her guests assume the risk of any and all accidents or injuries of any kind that may be sustained by, or in connection with, use of AB Fitness & Nutrition Inc facilities. AB Fitness & Nutrition Inc cannot guarantee that any facility or equipment is free of risk. Member agrees to use care in the use of AB Fitness & Nutrition Inc facilities, equipment and services and to protect against accidents by other members.
    Medical Disclaimer. Member has been informed and acknowledges that AB Fitness & Nutrition Inc makes no claims as to medical or fitness results that can or may be obtained through use of the AB Fitness & Nutrition Inc’s facilities, equipment or services. AB Fitness & Nutrition Inc has neither suggested nor will suggest any medical treatment to Member. Only licensed medical professionals are qualified to give medical advice.Member’s Health Warranty. Member represents that: (a) there are no medical or physical conditions that would preclude his or her use of AB Fitness & Nutrition Inc facilities; (b) he or she has not been instructed by any physician not to use AB Fitness & Nutrition Inc; and (c) he or she is in good health and has no disability, impairment, injury, disease or ailment preventing him or her from engaging in active or passive exercise or which could cause increased risk of injury or adverse health consequences as a result of exercise.
    Member Release and Indemnity. By entering into this Membership Agreement, and/or by attending sessions whether online or in person or otherwise participating in AB Fitness & Nutrition Inc activities, Member hereby acknowledges and agrees that there are inherent risks in exercise and in using the equipment associated with the AB Fitness & Nutrition Inc’s classes or instruction.  Member assumes the risk and full responsibility for the services provided by AB Fitness & Nutrition Inc and/or his/her use of the AB Fitness & Nutrition Inc’s facilities.  Member shall release, defend, indemnify and hold AB Fitness & Nutrition Inc and its affiliates, parents, insurers, subsidiaries, divisions, predecessors, heirs, successors, assigns, executors, administrators, and its current and former members, managers, officers, shareholders, directors, agents, contractors, employees, officers, directors, agents and attorneys harmless for any and all Claims, including reasonable attorneys’ fees, arising out of or in connection with this Membership Agreement and/or the services provided by AB Fitness & Nutrition Inc to the Member and/or the Members use of AB Fitness & Nutrition Inc’s facility except for injuries and damages directly or solely caused by the gross negligence of AB Fitness & Nutrition Inc.
    Prevailing Party. In the event the Member commences any action or proceeding against AB Fitness & Nutrition Inc and its affiliates, parents, insurers, subsidiaries, divisions, predecessors, heirs, successors, assigns, executors, administrators, and its current and former members, managers, officers, shareholders, directors, agents, contractors, employees, officers, directors, agents and attorneys and fails to obtain judgment or partial judgment in Member’s favor, Member shall be liable to AB Fitness & Nutrition Inc for all costs and expenses associated with AB Fitness & Nutrition Inc’s defense of the action or proceeding or any claims on which Member did not prevail, including reasonable attorney’s fees and costs.Costs of Collection. Member agrees to pay all costs, plus reasonable attorney’s and collection fees, in connection with AB Fitness & Nutrition Inc’s (or AB Fitness & Nutrition Inc’s designee’s) collection of any amounts owed by Member.Non-Discrimination. AB Fitness & Nutrition Inc will not discriminate against any person because of gender, race, creed, age, color, sexual orientation, national origin or ancestry in considering applications for, or have taken other action in connection with, membership in the AB Fitness & Nutrition Inc.
     It is understood and agreed that no failure or delay by any party hereto in exercising any right, power or privilege hereunder shall operate as a waiver thereof, nor shall any single or partial exercise preclude any other or further exercise or the exercise of any right, power or privilege hereunder.Enforcement. If any provision of this Membership Agreement is held to be invalid or unenforceable by a court of competent jurisdiction, such holding shall not affect the validity or enforceability of any other provisions of this Membership Agreement, which shall remain in full force and effect, and the provisions held invalid or unenforceable shall be deemed modified so as to give such provisions the maximum effect permitted by applicable law.
    Governing Law; Jurisdiction. This Membership Agreement shall be governed in all respects by the substantive law of the State of New York, without regard to its conflict of law principles. Member hereby unconditionally consents to submit to the jurisdiction of the federal and state courts sitting in the State of New York for any actions, suits or proceedings arising out of or relating to this Membership Agreement.
    Entire Agreement. This Membership Agreement and all rules and regulations of AB Fitness & Nutrition Inc, as revised from time to time, constitute the entire and exclusive agreement between the parties, and supersede all prior promises, representations, understandings and/or agreements relating to this membership. This Membership Agreement may be modified only by an instrument in writing and only by the Club.
    Because physical exercise can be strenuous and subject to risk of injury, including serious injury, the club urges you to obtain a physical examination from a doctor before using any exercise equipment or participating in any exercise activity. You (each member, guest, or participant) agree that if you engage in any physical exercise or activity, or use any club amenity on the premises or off premises including any  sponsored  club  event,  you  do  so   entirely  at  your  own  risk. Likewise, dietary modifications can cause a variety of changes and can create problems, including as it relates to your energy, stamina, appetite, and mood. Any recommendation for changes in diet including the use of food supplements, weight reduction and/or body building enhancement products are entirely your responsibility and you should consult a physician prior to undergoing any dietary or food supplement changes. You agree that you are voluntarily participating in these activities and use of these facilities and premises  and assume all risks  of injury, illness, or death. We are also not responsible for any loss of your personal property.
    This waiver and release of liability includes, without limitation, all injuries which may occur, regardless of negligence, as a result of: (a) your use of all amenities and equipment in the facility and your participation in any activity, class, program, personal training or instruction; (b) the sudden  and  unforeseen  malfunctioning  of  any  equipment; (c)  our  instruction,  training, supervision, or dietary recommendations; or (d) your slipping and/or falling while in the club, or on the club premises, including adjacent sidewalks and parking areas.  This also includes any negligence associated with the presence of or transmission of any bacteria, viruses, or infectious diseases.  
    By signing below, you acknowledge that you have carefully read this "waiver and release" and fully understand that it is a  release of liability. You expressly agree to release and discharge the health club, and all affiliates, employees, agents, representatives, successors, or assigns, from any and all claims or causes of action and you agree to voluntarily give up or waive any right that you may otherwise have to bring a legal action against the club for negligence, personal injury or property damage. You also agree that this waiver and release also applies to any guests or other participants you bring to the Club; should any such persons bring negligence, personal injury, or property damage claims against the Club, you agree to defend and indemnify the Club and hold the Club harmless against any such claims.
    You further agree that if a court of law finds any part of this agreement to be against public policy or in violation of any state statute or legal precedent, then the remainder of this document will remain in full force.
    Additionally, you understand that the Club occasionally photographs/videotapes client events/sessions and by initialing below you provide your express written approval for the Club to use these images or video in any and all media for promotional purposes, with no financial or other remuneration due to you.