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Derrick Johnson, Personal Trainer

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Waiver / Release of Liability

  • Name and Phone Number
  • Because physical exercise can be strenuous, it is recommended that I obtain a physical examination from a doctor before beginning any exercise activity.

    I, being mentally sound, understand that with exercise, strength training and/or cardiovascular activity there is a risk of injury and even death. I am aware of this risk and consider myself physically sound enough to participate in light, vigorous and/or strenuous exercise. I hereby assume all risk of injury, illness or death.

    I am voluntarily participating in these activities and fully understand that this is a release of liability. I agree to waive or give up any right that I, my spouse, my family members, or friends may otherwise have to bring legal action against SoLi Fitness LLC and/or Derrick D. Johnson, nor against the property owner, Laila Farally, for personal injury or property damage now or in the future.

    Any recommendations for change in diet, use of supplements or increased daily activity are my responsibility and I should consult a physician prior to making changes.

    To the extent that the statue or case law does not prohibit releases for negligence, this release is also for negligence.

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Online Personal Training Information

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  • Personal Information

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  • Name and Number
  • Lifestyle

  • The specifics of an occupation can sometimes create muscular imbalances in an individual.
  • Individuals who are seated for extended periods of time can sometimes develop tight hip flexors.
  • Individuals who are on their feet for long periods of time can sometimes develop tight lower leg muscles.
  • Individuals who wear shoes with heels on them while walking or standing a lot can sometimes develop tight lower leg muscles.
  • Individuals that work on a computer for extended periods of time can sometimes develop imbalances between their upper and middle back muscles
  • Exercise History

  • Exercise Availability

  • Physical Activity Readiness Questionnaire

  • I request a written permission from your physician before you participate in any physical activity or exercise. By signing here you acknowledge that I have requested permission for medical clearance but you choose not to do so and assume the risk of any injuries that may arise as a result of exercising due to a medical condition known or unknown.
  • By checking the box below, you are indicating that you are able to participate in physical activities or exercise. You have answered the questions honestly and maintain that you are healthy enough for physical exertion.
  • Just For Fun

  • Thank you for showing interest in SoLi Fitness Online Personal Training! Let’s get you going!