Health Coaching Individual 6 Month/Non-Athlete

This plan provides 12 sessions of health coaching in a 6-month period.

$625

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CrossFit Bemidji Liability Waiver (7117)
CrossFit Bemidji recommends that you clear your participation in any exercise program with your physician.

By signing below, I certify that I am sufficiently physically fit to participate in rigorous physical activity and I (and my parent or guardian, if I am a minor) hereby waive and release Natural Existence, LLC (doing business as CrossFit Bemidji), and any sponsors and organizers of the aforementioned entities and persons from any cause of action, loss, liability, claim demand or expense of any kind whatsoever which I or my heirs or personal representatives may have bodily injury or illness and for any other cost, damage or loss suffered or incurred by me or during my participation in the event and all related activities.  I acknowledge that I have either had a physical examination and have been given my physician’s permission to participate, or that I have decided to participate in the exercise activities, program, and use of equipment without prior approval of my physician and do hereby assume all responsibility for participation in said activities, programs and use of equipment.
 
I acknowledge that participating in CrossFit® and any activity including but not limited to, weightlifting, walking, jogging, running, aerobic activities, or any other sporting or recreational endeavor, and receiving coaching in these activities is a hazardous recreational activity with risk of personal injury including paralysis or death.  CrossFit Bemidji has made me fully aware that the fitness programs/classes, which CrossFit Bemidji offers and in which I desire to participate, are of a nature and kind that are extremely strenuous and can/may push me to the limits of my physical abilities.  I, the undersigned, recognize and understand that the programs/classes are not without varying degrees of risk which may include, but are not limited to, the following:  Injury to the musculoskeletal and/or cardio respiratory systems which can result in serious injury or death, injury or death due to negligence on the part of myself, my training partner, or other people around me, injury or death due to improper use or failure of equipment, or injury or death due to a medical condition whether known or unknown by me.  I am aware that any of these above mentioned risks may result in serious injury or death to myself and or my partner(s).  I hereby certify that I know of no medical problems that would increase my risk of illness and injury as a result of participation in a fitness program designed by CrossFit Bemidji.  CrossFit Bemidji informed me that there exists the possibility of adverse physical changes during an exercise program, and I fully understand the same.  If I am engaged in online training, I acknowledge that I am not being monitored by any trainer and that there is no liability to the trainer, facility or studio if there is an injury sustained.

I HEREBY FULLY ASSUME THE RISKS OF INJURY, ILLNESS, DISABILITY, DEATH, OR LOSS OR DAMAGE TO PERSON OR PROPERTY INHERENT IN, AND/OR IN ANY WAY CONNECTED WITH, ATTENDING, PARTICIPATING IN, AND SPECTATING A CROSSFIT BEMIDJI EVENT OR OTHER CROSSFIT ACTIVITY AT THE FACILITIES EVEN IF ARISING FROM THE NEGLIGENCE OF OTHER PERSONS EXECUTING A SIMILAR WAIVER AND RELEASE FROM LIABILITY.
 
 I understand that I will not be permitted to Participate in CrossFit activities without executing this Waiver and Release. As a condition of my participation in CrossFit activities, I grant Natural Existence, LLC/CrossFit Bemidji, and its employees, members, partners, officers and agents perpetual and non-revocable permission to use my name, photographs and video in which my image and likeness appears in connection with my participation in CrossFit activities and further grant permission to display, publish, distribute, use, print and reprint such images and likeness, and the right to employ such images or likeness in advertising and promotions relating thereto or to CrossFit Bemidji or any activities at or related to CrossFit Bemidji, including any advertisements or media and electronic displays and transmissions thereof (herein “Likeness Rights”). I release CrossFit Bemidji and its employees, members, partners, officers and agents from any and all liability for damages for use in any manner or media of the Likeness Rights, and waive any and all claims and causes of action for damages for use of the Likeness Rights, including but not limited to: unauthorized use of my likeness, image, character or persona; violation of my right of publicity or privacy; and for copyright or moral rights infringement, defamation, or being cast in a bad light.

 I (and my parent or guardian, if I am a minor) recognize the there is risk involved in the types of activities offered by CrossFit Bemidji, and agree that I (and my parent or guardian, if I am a minor) accept financial responsibility for any injury that I or the participant may cause either to him/herself or to any other participant due to his/her negligence.  Should the above-mentioned parties, or anyone acting on their behalf, be required to incur attorney’s fees and costs to enforce this agreement, I agree to reimburse them for such fees and costs.  I further agree to defend, indemnify and hold harmless Natural Existence, LLC/CrossFit Bemidji, their principal agents, employees, and volunteers from liability for the injury or death of any person(s) and damage to property that may result from my negligent or intentional act or omission while participating in activities offered by CrossFit Bemidji.  I will be financially responsible for treatment, hospitalization and other medical care rendered to me in the event of my illness, injury or other medical emergency circumstances in connection with any and all activity at the CrossFit Bemidji facility.
 
 I AGREE NOT TO BRING ANY CLAIM AGAINST RELEASEES, which claims concern in any way death, injury, damage, or loss of any type or nature, which arise out of, are related to, or are in any way connected with attending, participating in, volunteering at or spectating at CrossFit Bemidji or weightlifting activities, and/or which arise out of or are connected in any way with my use of, or my presence at the Facility(ies) at which (those) activities held, whether injury, death or disability, loss or damage is caused in whole or in part by negligence, gross carelessness, or other acts or failure to act of those persons or entities.

 I HEREBY AFFIRM AND ACKNOWLEDGE THAT I HAVE READ THIS DOCUMENT. I HEREBY AFFIRM AND ACKNOWLEDGE THAT I UNDERSTAND ITS CONTENTS AND AGREE TO BE BOUND THEREBY. IF I AM UNDER THE AGE OF EIGHTEEN YEARS, MY PARENT/GUARDIAN HAS READ AND COMPLETED THE SECTION BELOW.

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Health Coaching Individual 6 Month/Non-Athlete Contract
Six Month Health Coaching Program Agreement

Welcome! During the coming six months, you will learn ways to help yourself achieve a healthier diet and lifestyle. Please read the following. If anything is unclear, please ask.
                                                                                 
This Agreement is made today between the Coach of the Program and the person named at the end of this document, [the Client].  The Program in which you are about to enroll in will include all of the following:
  1. Two 50-minute appointments each month for six months, which will include a discussion of your progress, recommendations, and a full set of notes.
  2. Monthly special events like tele-classes, group seminars, and/or workshops related to health and wellness, if available.
  3. A variety of handouts, recipes, books, food samples, and other materials.
I [the client] am committed to my own personal health and wellness. With this commitment I give my word to:
  • Be coachable
  • Be open to new foods, concepts, and exercises
  • Fulfill on the commitments I make
  • Eat nourishing foods according to the guidance of my Health Coach
  • Exercise according to the guidance of my Health Coach
  • Finding a healthy balance between work and play
  • Give gratitude in the relationships in my life
  • Develop a listening to my body’s wants and needs
  • Powerfully deal with the stressors in my life
  • Begin and end our sessions on time

SCHEDULING
As your Coach, I understand that my clients have busy schedules and I take pride in not keeping them waiting or keeping them longer than planned. Each session will end 50 minutes after it was scheduled to begin. Please be on time. If the Client needs to cancel or reschedule the appointment, the Client must do so 24 hours in advance; otherwise, the Client will forfeit that appointment and will not have an opportunity to reschedule it.
Please refer to the Program Schedule for session details.
This program expires if all 12 sessions have not been completed within two months after the End Date specified above.

PAYMENTS AND REFUNDS
The Client understands that the regular cost of the Program is $900 for six months. However, registration today reduces that cost to $750 at $125 a month.  If you prefer some savings you can make one full payment of $625 due the first session, which is a free month of health coaching.  In the event of the Client’s absence or withdrawal, for any reason whatsoever, the Client will remain responsible for the pro-rata share of the program that has been delivered, plus a cancellation fee of $50.  The Coach reserves the right to cancel the program if at any point she or he feels it is not advantageous for the coaching program to continue. If this happens, the Client is only responsible for the pro-rata share of coaching services received.

DISCLAIMERS 
The Client understands that the role of the Health Coach is not to prescribe or assess micro- and macro-nutrient levels; provide health care, medical or nutrition therapy services; or to prevent, diagnose, treat or cure any disease, condition or other physical or mental ailment of the human body. Rather, the Coach is a mentor and guide who has been trained in holistic health coaching to help clients reach their own health goals by helping clients devise and implement positive, sustainable lifestyle changes. The Client understands that the Coach is not acting in the capacity of a doctor, licensed dietitian-nutritionist, psychologist or other licensed or registered professional, and that any advice given by the Coach is not meant to take the place of advice by these professionals. If the Client is under the care of a health care professional or currently uses prescription medications, the Client should discuss any dietary changes or potential dietary supplements use with his or her doctor, and should not discontinue any prescription medications without first consulting his or her doctor.  
The Client has chosen to work with the Coach and understands that the information received should not be seen as medical or nursing advice and is not meant to take the place of seeing licensed health professionals.

PERSONAL RESPONSIBILITY AND RELEASE OF HEALTH CARE RELATED CLAIMS
The Client acknowledges that the Client takes full responsibility for the Client’s life and well-being, as well as the lives and well-being of the Client’s family and children (where applicable), and all decisions made during and after this program.  
The Client expressly assumes the risks of the Program, including the risks of trying new foods or supplements, and the risks inherent in making lifestyle changes. The Client releases the Coach from any and all liability, damages, causes of action, allegations, suits, sums of money, claims and demands whatsoever, in law or equity, which the Client ever had, now has or will have in the future against the Coach, arising from the Client’s past or future participation in, or otherwise with respect to, the Program, unless arising from the gross negligence of the Coach.

CONFIDENTIALITY
The Coach will keep the Client’s information private, and will not share the Client’s information to any third party unless compelled to by law.

ARBITRATION, CHOICE OF LAW, AND LIMITED REMEDIES
In the event that there ever arises a dispute between Coach and Client with respect to the services provided pursuant to this agreement or otherwise pertaining to the relationship between the parties, the parties agree to submit to binding arbitration before the American Arbitration Association (Commercial Arbitration and Mediation Center for the Americas Mediation and Arbitration Rules). Any judgment on the award rendered by the arbitrator(s) may be entered in any court having jurisdiction thereof. Such arbitration shall be conducted by a single arbitrator. The sole remedy that can be awarded to the Client in the event that an award is granted in arbitration is refund of the Program Fee. Without limiting the generality of the foregoing, no award of consequential or other damages, unless specifically set forth herein, may be granted to the Client.
This agreement shall be construed according to the laws of the State of Minnesota.  In the event that any provision of this Agreement is deemed unenforceable, the remaining portions of the Agreement shall be severed and remain in full force.    
If the terms of this Agreement are acceptable, please sign the acceptance below. By doing so, the Client acknowledges that: (1) he/she has received a copy of this letter agreement; (2) he/she has had an opportunity to discuss the contents with the Coach and, if desired, to have it reviewed by an attorney; and (3) the client understands, accepts and agrees to abide by the terms hereof.