Everything we do to serve you is tailored exactly to your needs. We ask all new clients to share as much information with us as possible about your body and your health, so that we may serve you as sensitively as possible.

​Before your first appointment or class, please take some time to thoroughly fill out these New Client Information Forms and Waiver. You have a few options for how to do so below.
​Thank you in advance! We look forward to working with you.

NEW CLIENT ​INFORMATION FORM & WAIVER

OPTION 1

FILL OUT ONLINE
If you'd prefer to securely fill out this form online, you may do so below.

    CENTERLINE MOVEMENT, LLC 
    WELLNESS TRAINING
    ​RELEASE FORM 

    Because physical exercise can be strenuous and subject to risk of serious injury, Centerline Movement, LLC (“Centerline Movement”) and your personal trainer urges you to obtain a physical examination from a doctor before beginning any exercise or training program. 

    I represent that I am in good physical condition and have no medical reason or impairment that might prevent me from my intended use of any amenities and equipment in the facility or any off site location and/or my intended participation in any activity, class, program, personal training or instruction. I acknowledge that Centerline Movement did not give me any medical advice relating to my physical condition and/or ability to use any amenities and equipment in the facility and any off site location and/or to participate in any activity, class, program, personal training or instruction before such use or participation. If I have any health or medical concerns now or before such use or participation in the future, I will discuss them with my doctor and advise Centerline Movement regarding such health or medical concerns immediately and fully. 

    I agree that by participating in these physical exercise sessions or personal training activities, I do so entirely at my own risk. I am voluntarily participating in these activities and use of these facilities and premises and assume all risks of injury. This includes, without limitations, any physical or emotional injury, including death, and loss or damage to my personal property 

    I agree that Pilates, TRX Suspension Training®, Functional Movement, and GYROTONIC® Training, resistance training, flexibility training and related exercise and training activities are inherently dangerous activities in which participants and other individuals are under constant risk. I am fully aware of the potential dangers of engaging in exercise activities (such as Pilates, TRX Suspension TrainingTM, Functional Movement, and GYROTONIC® Training, resistance training, flexibility training, weight lifting, cardiovascular exercise, group exercise classes, and other exercise activity and massage therapy).

    In consideration of permitting me to use any amenities and equipment in the facility and any off-site location and/or to participate in any activity, class, program, personal training, wellness training or instruction, I agree to voluntarily release from and assume all liability and damages, and agree to indemnify, defend, and hold harmless Centerline Movement and its members, directors, officers, employees, independent contractors and representatives (including attorney’s fees and costs) for any death, physical or emotional injury or loss or damage to personal property damage suffered by any person, including myself, caused by or resulting from on in connection with, whether in whole or in part: (a) use of any amenities and equipment in the facility and any off-site location and/or participation in any activity, class, program, personal training or instruction; (b) the sudden and unforeseen malfunctioning of any equipment; or (c) any instruction, training, supervision, or dietary recommendations received from Centerline Movement, even if such death, injury, loss or damage is caused by Centerline Movement’s own negligence.

    If any portion of this Release shall be deemed by a Court of competent jurisdiction to be invalid, then the remainder of this Release shall remain in full force and effect and the offending provision or provisions severed here from. 

    I ACKNOWLEDGE THAT I HAVE CAREFULLY READ THIS RELEASE AND FULLY UNDERSTAND THAT IT IS A RELEASE OF ALL LIABILITY. IN ADDITION, I HEREBY WAIVE ANY RIGHT THAT I MAY BRING A LEGAL ACTION OR ASSERT A CLAIM FOR DEATH, INJURY, LOSS OR DAMAGE OF ANY KIND AGAINST CENTERLINE MOVEMENT (including its members, directors, officers, employees, independent contractors and representatives) AS THE RESULT OF NEGLIGENCE OR OTHERWISE ARISING OUT OF OR RELATING TO MY PARTICIPATION IN ANY OF THE ACTIVITIES, OR USE OF THE EQUIPMENT, FACILITIES OR SERVICES CENTERLINE MOVEMENT PROVIDES. 
    I acknowledge that my name below represents my signature.
    Thank you! We appreciate your time and energy.

OPTION 2

DOWNLOAD & PRINT
Please download, print, fill out, and sign this form:
New Client Information Form and Waiver.pdf
File Size: 96 kb
File Type: pdf
Download File
Bring completed form to your first appointment.
​Or email to us at: movewell@centerlinemovement.com.