Jaguar Program

Create a new account

By submitting the form, I (we) hereby state, to the best of my (our) knowledge, my (our) answers to the above questions are complete and correct. I also agree to the terms of the above Waiver and Release.
General Information
First Name:
Last Name:
Email Address:
Date of Birth:	Month: Day: Year:
Gender:	Male Female
Height:
Weight:
Chosse a password: (at least 5 characters)
Retype password:
If you have a referral code, please enter here:
Medical and Insurance Information
Name of parent/guardian:
Please indicate all conditions that apply to the participating athlete or members of his/her family (brother, sister, father, mother, aunt, uncle, grandparent) and note relationship or additional concerns:	asthma/allergies headaches gallbladder arthritis seizures/epilepsy liver disease high blood pressure stroke kidney disease	high cholesterol thyroid disorder diabetes tuberculosis heart disease chronic lung disease bleeding/clotting disorder ulcers
	Other, please explain:
Has the athlete ever fainted or passed out? If yes explain.
List all medication the athlete is currently taking:
List all medical conditions currently undergoing treatment:
List all prior injuries and dates of occurance:
Please describe any type of surgeries, rehabilitation, or other pertinent information that goes with any injury or medical condition previously noted.
Waiver and Release Information
1. Waiver and Release. You (Buyer, Client, parent, spouse, or guest, as applicable) agree that if you engage in any physical exercise or activity, you do so at your own risk. This includes, without limitation, your use of equipment and your participation in any activity, class, program, personal training or other instruction now or in the future made available. You agree that you are voluntarily participating in these activities and using the equipment and facilities and assuming all risk of injury or your contraction of any illness or medical condition that might result. You agree on behalf of yourself (and your personal representatives, heirs, executors, spouse, administrators, agents, assigns or others) to release and discharge us (and our affiliates, employees, agents, representative, successors and assigns) from any and all claims or causes of action arising out of our negligence. This waiver and Release of all liability includes, without limitation, injuries which may occur as a result of (a) your use of any exercise equipment which may malfunction or break, (B) our negligent instruction or supervision, (c) our negligent hiring or negligent retention of any employee, 2. Client's responsibilities as to entering physical activity: You (Buyer, each Client and all guests) should consult with your physician in all events, including a history of heart disease, before using our personal Training services and participation of this exercise program. You understand and acknowledge that we have no expertise in diagnosing, examining or treating any medical condition. You agree you will not use our services with any medical condition, including open cuts, abrasions, sores, infections, maladies or inability to maintain personal hygiene, if such condition poses a direct threat to the health or safety of yourself or others, and agree you will use the services in accordance with all applicable public health requirements. It is your responsibility to consult with you physician to determine if any of these medical conditions exists and, if so, whether such condition poses a direct threat to the health or safety of yourself or others. The company reserves the right to make the final determination in this regard. 3. If there are any medical issues including current therapies or restrictions from you participating in physical activity it is your "the client" responsibility to contact Jaguar PT at: 305-742-4368 to discuss further participation within the workout program. 4. You have acknowledged that you have carefully read this waiver and release and fully understand that it is a release of all liability. In addition, you do hereby waive any right that you may have, by or on behalf of yourself, your spouse or any child (Minor or otherwise), to bring a legal action or assert a claim for injury or loss of any kind against us for our negligence or arising out of or relation to participation by you, your spouse or child in any of the activities, or use of the equipment, facilities or services we provide as described in this paragraph, or on account of any illness or accident, or damage to or loss of you personal property. 5. This form is correct and valid for 1 year unless otherwise stated in writing provided by the client or client's guardian that must be signed and dated by both a managing member of Jaguar PT and client or guardian.
ATHLETE SIGNATURE: (Type full name) DATE: If you are under the age of 18 this must be signed by a parent or legal guardian. When you sign this waiver you are acknowledging and agreeing to all terms and conditions.

Create a new account

General Information

First Name:

Last Name:

Email Address:

Date of Birth:

Gender:

Height:

Weight:

Chosse a password:(at least 5 characters)

Retype password:

If you have a referral code, please enter here:

Medical and Insurance Information

Name of parent/guardian:

Please indicate all conditions that apply to the participating athlete or members of his/her family (brother, sister, father, mother, aunt, uncle, grandparent) and note relationship or additional concerns:

Has the athlete ever fainted or passed out? If yes explain.

List all medication the athlete is currently taking:

List all medical conditions currently undergoing treatment:

List all prior injuries and dates of occurance:

Please describe any type of surgeries, rehabilitation, or other pertinent information that goes with any injury or medical condition previously noted.

Waiver and Release Information

By submitting the form, I (we) hereby state, to the best of my (our) knowledge, my (our) answers to the above questions are complete and correct. I also agree to the terms of the above Waiver and Release.

Chosse a password:
(at least 5 characters)