Credit Card Type. â MC. â Visa. Credit Card Number: ... OBLIGATION ABSOLUTE: You are obligated to pay us the entire
Across the Parking Lot Under Maritime Dance
Monday
y
da s e n d e and W
3-4pm
October 12/17/19/24/26/31 November 2/7/9/16
Rocky Lake Jr. High Offers
Afitness program that runs out of ProEdge Sports Conditioning after school from 3-4pm. This program is for any student who is looking to improve their fitness level or add to their conditioning, building on their strength and speed.
For a better idea of the type of fitness training offered visit www.proedgetraining.com/ to watch video
10 Sessions $50
I am signing up for the Monday/ Wednesday Group at ProEdge from 3-4pm
To Register ...
$50 cheque made out to Rocky Lake Junior High or cash
Student’s Name ___________________________________
Class ________________
Parent ______________________________ Contact Number: _____________________________ Contact Email Address: _________________________________________
Bring form and payment to Mrs. Griffin in Room 308
Any Questions Contact
[email protected]
PROEDGE TRAINING PROGRAM AGREEMENT PROEDGE TRAINING PROGRAM AGREEMENT (the "Agreement") BY SIGNING THIS AGREEMENT YOU WILL WAIVE CERTAIN LEGAL RIGHTS, INCLUDING THE RIGHT TO SUE. PLEASE READ CAREFULLY.
Name: ____________________________________________ ("you") Agreement No.: _____________________ Address: _____________________________________________________________________________________ Date of Birth: _________________________________ Phone No.: _____________________ (Cell / Home / Work) Email: ________________________________________________________________________________________ Membership No.: __________________________ (by ProEdge Representative) Thank you for choosing a ProEdge Training Program (the "Program") with ProEdge Sports Conditioning Ltd. ("ProEdge" and/or "PROEDGE" and or "We"). We want you to feel 100% comfortable with your ProEdge Training Program. Please take up to five (5) days to read everything in this Agreement. If you are not satisfied with the explanation of any part of this Agreement, you have five (5) days after signing to rescind with a 100% money back guarantee! Our goals are to help you achieve the results you are looking for and to make your fitness experience an enjoyable one. In exchange for payment by you on terms set out below, and commencing immediately after signing this Agreement, you have the right during the duration of the Agreement to receive, at the ProEdge Facility where the Agreement is executed (the "Facility"), the specified number of training sessions ("Session(s)") with a personal trainer ("Personal Trainer"), or completion of another program as identified below. Sessions will be scheduled at mutually convenient times for you and your Personal Trainer. Commit to your success. • You agree to arrive at least ten (10) minutes prior to your scheduled appointments. If you arrive late for any session, your appointment will finish at the originally scheduled completion time. ______ • You agree and acknowledge that it is your responsibility and not the responsibility of your Personal Trainer, to monitor your physical condition and if you feel lightheaded, dizzy, nauseous, or experience pain or discomfort at any time during a training session, and that you will immediately stop the activity and inform your Personal Trainer. ______ • You agree to inform your Personal Trainer of any conditions or changes in your health at any time whilst participating in the Program, which might affect your ability to exercise safely and with minimal risk of injury. ______ • You are not obliged to perform or participate in any activity unless you wish to, and have the right at all times to decline participation in a training session. ______ • You agree to provide at least twenty four (24) hours notice to the Personal Trainer if you wish to cancel a scheduled appointment. If an appointment is cancelled with less than twenty four (24) hours notice you will be charged for that training session. ______ • We may, if we choose, cancel your ProEdge Training if we feel there is a lack of commitment to the program or a failure to comply with the terms of this Agreement. If we choose to cancel this agreement ProEdge will refund the remainder of any unused sessions. ______ • Sessions must be completed within twelve (12) months of the date of this Agreement. ______ • We request that you do not offer your Personal Trainer gratuities as this is neither necessary nor expected. We do encourage you to notify the Club Manager and/or ProEdge Directors, if you feel your Personal Trainer has done an outstanding job. ______ I, the Member, have carefully read all pages of this ProEdge Training Agreement. I have been given a copy of it. I confirm that no verbal representations or warranties have been made to me which have not been confirmed in writing in this agreement, and that this written Agreement accurately sets out the entire agreement between us. I understand the terms and conditions and agree to be bound by them. Dated at 36 Duke Street, Bedford, NS, B4A 2Z2, this __________ day of __________________________ 20 ___
Name of Member (Please Print):______________________________ Witness Name (Please Print): __________________________________ Signature of Member: ____________________________________ Signature of Witness: ________________________________________ Signature of Parent Parent or Guardian or Guardian (if applicable)*: __________________________________ Name (Please Print):________________________________________ * As Parent or Guardian, I am aware that there are no professional health care staff monitoring my child’s physical condition and that there may be times that my child will not be supervised. My child will be using the ProEdge Facility at his or her own risk.
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PROEDGE TRAINING PROGRAM AGREEMENT PROGRAM AND PAYMENT DETAILS Type of Program:
☐ Group Athletics
☐ Personal Training ☐ Team Training
☐ Small Group Training ☐ Camps
☐ Specialty Programs _____________________________________________ (please specify) Number of Sessions: _____________________ Rate per Session:
_____________________
Cost of Program:
_____________________
Applicable Tax:
_____________________
Total Cost:
_____________________
Amount Paid:
_____________________
Amount Financed:
_____________________
Program Notes (by ProEdge Trainer): _____________________________________________________________________________________________________________________ _____________________________________________________________________________________________________________________ _____________________________________________________________________________________________________________________ _____________________________________________________________________________________________________________________ _____________________________________________________________________________________________________________________ _____________________________________________________________________________________________________________________ ProEdge Trainer Signature:
___________________________________
Payment Information: Payers Name:
__________________________________________________________
ID Type:
_______________________
Payers Signature:
__________________________________________________________
Bank Name:
________________________________________________________________________________________________
Bank Address:
________________________________________________________________________________________________
Account No.:
__________________________________________________________
Credit Card Type
☐ MC
Credit Card Number:
__________________________________________________________
Cardholders Signature:
__________________________________________________________
Transit No.:
_______________________
Expiry:
_______________________
☐ Visa
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PROEDGE TRAINING PROGRAM AGREEMENT PERSONAL TRAINING SATISFACTION GUARANTEE We are confident that you will be entirely satisfied with your Program. If you are at any time dissatisfied with your "ProEdge Training" or "Specialty Program", or your Personal Trainer cannot continue with your training, ProEdge management will provide you with another qualified Personal Trainer to resume and complete your remaining Sessions at your request. The services you will receive will be defined within your Assessment Program Proposal.
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RELEASE: You acknowledge that there is a risk associated with participation in fitness activities and in exercising. Your participation in the Program is completely voluntary and you acknowledge that you are assuming all risk of injury to yourself or others including any illness or medical condition. Please raise any concerns about starting an exercise or fitness program with your physician before starting the Program. You agree on your own behalf (and on behalf of your personal representatives, heirs, estate trustees or assigns) to (a) release, indemnify and discharge ProEdge, and its franchises (where applicable) including its/their representative owners, officers, directors, agents, employees or independent contractors, from any and all claims or causes of action (known or unknown) which you may have arising out of our negligence, including the negligence of our staff, agents or representatives, and (b) to indemnify and save us harmless from any and all claims or causes of action (known or unknown) brought against us by any party arising out of your actions, including your negligence, whilst at the Facility or participation in the Program, whether at the Facility, your residence or elsewhere. YOUR RESPONSIBILITIES: By signing this Agreement you agree to: (a) pay us the Fees when due, irrespective of your use of the Sessions, (b) all of the terms and conditions which are set out in this Agreement, (c) to follow our rules and regulations ("Rules") which may be posted at the Facility from time to time; and (d) to immediately notify us of address changes and of any other personal information changes. PAYMENT OBLIGATION ABSOLUTE: You are obligated to pay us the entire amount owing under this Agreement. Subject to your statutory rescission rights, you agree that this Agreement may not be cancelled for any reason by you, and no refunds will be issued. DEFAULT: If you breach any terms of conditions of this Agreement, or if you do not pay an installment on a payment date you will be in default. Your right to receive sessions will be suspended immediately and you will be subject to the Default Charge specified in Schedule A. We may then, if we choose, also immediately cancel your Sessions and keep any amounts you have paid to us. If we later accept a payment from you, you must fulfill all your remaining responsibilities under this Agreement. We may require you to pay any legal; and/or collection fees and charges incurred by us in collecting your overdue payments from you. PRE-‐AUTHORIZED DEBIT PAYMENT AGREEMENT: If you have taken advantage of the ProEdge Staged Payment Plan through Pre-‐Authorized Debit (PAD) Payments, the Schedule A must be completed in full, and forms part of this Agreement. You agree to pay the Fees on each regular payment date and authorize and direct ProEdge to present transactions for payment against your cheque or credit card account. In consideration of ProEdge acting as directed, you agree that ProEdge's treatment of each cheque or credit card payment and our rights respecting each cheque or credit card payment, shall be the same as if it were personally signed by you or by each of you if more than one. The pre-‐authorized payment shall be drawn on your account to cover all Fees, including all default charges, and other amounts to which we are entitled under this Agreement. You have certain recourse rights if any debit does not comply with this Agreement. For example you have the right to receive reimbursement for any debit that is not authorized or is not consistent with this PAD (Pre-‐Approved Debit) Agreement. To obtain more information on your recourse rights, contact your financial institution or visit www.cdnpay.ca. You may revoke your authorization at any time, subject to providing notice of 30days in writing to ProEdge Sports Condition Ltd., 36 Duke Street, Bedford, B4A 2Z2. To obtain a sample cancellation form, or for more information on your rights to cancel a PAD Agreement you may contact your financial institution or visit www.cdnpay.ca. You agree that these services are for PERSONAL use. MINORS: If you are a minor (under 19 years of age in Nova Scotia) your parent or guardian must endorse this agreement on page 1. NO VERBAL AGREEMENTS: There are no promises, representations, understandings or agreements between us other than those included in this Agreement. Any changes to the Agreement must be in writing, signed by both you (and your parent or guardian, if applicable) and ProEdge. This Agreement is subject to acceptance by the Facility Management and is null and void if not completed according to our current pricing and payment schedules. Any changes or deletions by you to any printed portion of this Agreement are null and void. WARRANTY: We warrant that the services supplied under this Agreement are of a reasonably acceptable quality, but other than specific guarantees in this Agreement, we make no other warranty or guarantee regarding the services available to you under this Agreement. ASSIGNMENT: This Agreement is personal to you. You may not assign, sell or transfer this Agreement or your rights under it to anyone else without the prior written approval of the Facility Management and any such attempted sale, assignment or transfer will be ineffective and will result in the immediate cancellation of this Agreement without refund. ASSIGNMENT BY PROEDGE: We may assign this Agreement to another company or person at our discretion, and the term "ProEdge" includes any assignee, who will have all our rights and powers under this Agreement. If any claims are brought against us under this Agreement, after we have assigned it, we reserve the right to raise any defenses available to us under this Agreement. LIMITATIONS OF DAMAGES: Your entitlement to damages, costs or recovery in any claims brought under this Agreement shall not exceed amounts paid by you under this Agreement. SEVERABILITY OF PROVISIONS: The provisions of this Agreement are severable. If a Court decides that any provision is illegal or unenforceable, the rest of the Agreement is still enforceable. If we choose at any time not to enforce a particular provision, we will still have the right to later enforce such provision. GOVERNING LAW: This Agreement is governed by the laws of the province in which it is signed and the laws of Canada applicable therein.
* ProEdge Sports Conditioning Ltd. ("ProEdge" or "PROEDGE"), 36 Duke Street, Bedford, NS, Canada, B4A 2Z2
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ADDITIONAL TERMS
PROEDGE PAR-Q The Physical Activity Readiness Questionnaire (PAR-Q) is a 1-page form to see if you should check with your doctor before becoming much more physically active. Please read the questions below carefully and answer each honestly: Check YES or NO
YES
NO
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Has your doctor ever said that you have a heart condition and that you should only do physical activity recommended by a doctor? 2. Do you feel pain in your chest when you do physical activity? 3. In the past month, have you had chest pain when you were not doing physical activity? 4. Do you lose balance because of dizziness or do you ever lose consciousness? 5. Do you have a bone or joint problem (for example, back, knee or hip) that could be made worse by a change in your physical activity? 6. Is your doctor currently prescribing drugs (for example, water pills) for your blood pressure or heart condition? 7. Do you know of any other reason why you should not do physical activity? 8. Have you had surgery in the last 2 years? 9. Do you experience or have a family history of the following? ☐Stroke ☐High Cholesterol ☐Cancer ☐Arthritis ☐Asthma ☐High Blood Pressure ☐Low Blood Pressure ☐Fibromyalgia ☐Depression ☐ Weight problems ☐YoYo Dieting ☐ Osteoporosis ☐Diabetes ☐Heart Disease ☐Other: Pain/stiffness in: ☐Back ☐Knees ☐Neck ☐Shoulders ☐Other: 10. Are you currently taking any medications (aspirin, Tylenol, birth control, etc…?) If yes, what?
If you answered YES to one or more of the questions above please talk to your doctor by phone or in person BEFORE you start becoming physically active. Tell your doctor about the PAR-Q and which questions you answered YES. “I have read, understood and completed this questionnaire. Any questions I had were answered to my full satisfaction.” Name:
__________________________________
Signature*: __________________________________ Date: *Signature of Parent or Guardian (for athletes under the age of majority)
__________________
Witness (Trainer):
__________________
__________________________________
Date:
Note: This physical activity clearance is valid for a maximum 12 months from the date it is completed and becomes invalid if your conditions change so that you would answer YES to any of the above questions.
Rock
y Lake
FIT CREW
Rocky Lake Junior High FITCrew STUDENT MEDIA RELEASE FORM I,
, hereby (Name of Student or Parent/Guardian if Student is under 18 years of age)
consent to my child/children being: (print, website and twitter), photographed by the teacher liaison and employees, agents or servants of the Halifax Regional School Board on
for the duration of our FITCrew sessions at ProEdge Sports Conditioning. Name of Student: Contact Telephone Number:
Rocky Lake Junior High School
(Signature of Student or Parent/Guardian if Student is under 18 years of age)
(Date)
