Name *

First Name

Last Name

Date *

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You acknowledge it is your responsibility to work directly with your doctor before, during, and after seeking consultation with Leftfield Training. As such, any information shared by Leftfield Training, its agents, officers, and employers and any affiliated companies is not to be followed without the prior approval of your doctor. *

Please mark each check box confirming you have read and understood each of the terms and conditions as listed below.

READ

You acknowledge that if you use this information without the prior consent of your doctor, you are agreeing to accept full responsibility for your decisions and are agreeing to hold harmless Leftfield Training, its agents, officers, and employers and any affiliated companies from any liability with respect to injury to you or your property arising out of or connected with your use of any information provided. *

READ

You acknowledge that any and all information is provided on the understanding that it applies only to an otherwise healthy individual. No information or recommendation is made with respect to, or are applicable to, any medical condition(s). *

READ

By your accepting any exercise and nutrition program, you agree to defend, indemnify, and hold harmless Leftfield Training and its subsidiary and other affiliated companies, and their employees, contractors, officers, and directors from all liabilities, claims, and expenses, including attorney's fees, that arise from your use, or misuse, of any exercise and nutrition information. *

READ

If your health status changes at any time (i.e. injury or medical condition) you must notify your coach so appropriate modifications can be made to your program. Injury or illness does not release you from your obligations under this agreement. Payments are not refundable. *

READ

You acknowledge the fee payable is based on your entitlement to attend classes and not your actual attendance. Failure to attend classes does not release you from your obligations under this agreement. Payments are not refundable. *

READ

You acknowledge this program demands your total commitment and all nutrition classes operate on a scheduled appointment basis. Accordingly, any cancellations require that you provide at least 24 hours notice. Any re-scheduled class is then made at the discretion of Leftfield Training. *

READ

Transaction fees may apply to some credit cards as per the Ezidebit schedule. *

READ

You acknowledge that with 30 days notice you can cancel your participation in the course at any time. Payments are not refundable *

READ

Leftfield Training retains the right to terminate this agreement for any reason including but without limitation to, clients failure to follow direction or conduct such as to adversely effect participation of other paying clients or contrary to the interests of this agreement. *

READ

You acknowledge that as detailed in the Leftfield Guarantee, at course end and upon a 75% rate of completion, if you are not satisfied for any reason you can either repeat the program free of charge, or choose to receive a refund in full, at your discretion. *

READ

I authorise Leftfield Training to process on my account due date all charges I have incurred for the previous month, if any, as well as all fees due in advance. I have read and understood, and agree to all terms and conditions. *

YES

NO