InstagramThis field is for validation purposes and should be left unchanged.Name(Required) First Last Address(Required) Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Email(Required) Phone(Required)Date of Birth(Required) MM slash DD slash YYYY Age(Required)Emergency Contact Name(Required)Consent(Required) I agree to the information below:The exercise sessions I will be involved in and will perform are recreational or self-directed in nature and will consist of progressive exercise levels that are determined and regulated by my trainer. The exercise sessions will consist of aerobic and weight training as well as education and instruction. The exercises are designed to place a gradually increasing stress on teh body and as such to improve the body's function, although no guarantee can be made. Consent(Required) I agree to the information below:I am aware that it is my choice to participate in the training program and I am free to discontinue any activity at any time without prejudice to me. I also assume full responsibility during and after my participation for any risk, discomfort, or fatigue I may experience. I understand that the responses from my body as to exercise and cardiovascular activity is unpredictable. I acknowledge that is my responsibility and obligation to inform the staff of any pain, discomfort, fatigue, or any other symptoms that I may experience. Consent(Required) I agree to the information below:I understand that I may ask questions or request further information regarding any of the activities, programs, services offered at any time before, during, or after participation. I am aware that I may take as long as I need to think the program over and can participate now or withdraw at any time. Once a program is purchased, all sales are final. Client Agreement(Required) I agreeBy agreeing to this box, you acknowledge and agree that you have read the information above and understand the nature of the activities at JL F.I.T. and you agree to all the terms listed in this agreement and acknowledge that you have received a copy of it. Client Signature(Required)Trainer SignatureDate(Required) MM slash DD slash YYYY