Skip to content
Facebook
Youtube
User
Schedule A Free Consultation
Home
About
Group Fitness Classes
Virtual Fitness Studio
Fitness Blog
Events
Login
My Account
Edit Profile
Reset Password
Menu
Home
About
Group Fitness Classes
Virtual Fitness Studio
Fitness Blog
Events
Login
My Account
Edit Profile
Reset Password
Free Consultation
[product_table id="3898"]
Guest Information
Name
(Required)
First
Last
Email
(Required)
Phone Number
Emergency Contact Name
(Required)
First
Last
Emergency Contact Phone Number
(Required)
APPLICANT’S ASSUMPTION OF LIABILITY/RISK
Please Note:
The applicant (with parental/guardian approval if the applicant is a minor) desires to participate in weight and/or aerobic training program instructed by Keisha Backstrom-Clayborn (Trainer), being fully aware of the possibilities of incurring physical injuries. If accepted into this weight and/or aerobic training program with Keisha Backstrom-Clayborn (Trainer), the applicant (with parental/guardian approval if the applicant is a minor), hereby assumes any and all liability and risks of personal injury that may able associated with participation in the program. The applicant (with parental/guardian approval if the applicant is a minor) also agrees to hold Keisha Backstrom-Clayborn (Trainer) as well as any and all agents acting on behalf of Keisha Backstrom-Clayborn (Trainer) and the acting facility in which the class is being held, blameless for any and all personal injuries sustained by the participant while participating in the program. It is therefore strongly recommended that each participant receive a complete physical and have the approval of a physician before starting this or any other weight and/or aerobic training program.
(Required)
I agree to APPLICANT’S ASSUMPTION OF LIABILITY/RISK
Scroll to Top
Schedule
Today,
Your Free Consultation
Complete Form Below
Name
Email
Phone Number
I am Interested In:
GROUP CLASSES
PERSONAL TRAINING
Lets Get Started