Result Based Training

Personal Training, Team Training, Mt Maunganui, New Zealand

Membership Form

Client Application & Pre activity Questionnaire

Applicants Details

*
*

Training Membership Options

OPTION ONE : TEAM Training (weekly payment options)
OPTION TWO: PERSONAL TRAINING (options)
OPTION THREE: RBT ACADEMY (11- 16 year old)

Medical Declaration

Have you ever had? *
Are you pregnant? *
Do you Smoke *
Are you taking any medication? *

The Fine Print

Risk Declaration
Hi trainer,
I’m excited to get started getting you fit, and if you’ve been with me a while I’m
looking forward to keeping you active. Whether you’re new or have been training
with me before, I need you to read over the below, ask me any questions you may
have, and then sign this document to confirm you understand the risks of working
out with Result Based Training Group Fitness and Personal training sessions.
By signing the below you confirm you understand that:
• We train indoors and outdoors.
• Team training is outdoors at venues around the local Mount Maunganui area. Usually around Mt Drury, at and around the cricket pavilion at Blake Park, or at Laura’s house on Campbell Road. From
time to time we are at other locations in Mount Maunganui;
• Personal training is at the RBT Studio on Campbell Road and outdoors on occasion.
• When we exercise on grass there can be pot holes, rough terrain, and debris;
• When we are running up hills, there are steps, rocks, and unstable ground;
• Running or walking on wooden and concrete surfaces can be slippery,
especially when wet or sandy;
• It can be dark at certain times of year;
• There are often other training groups, members of the public, and cars very
near where we train and we need to be aware of their activities and space;
• We use specialised exercise equipment that can be heavy and slippery that can
cause harm to you and other people if they are used carelessly;
• You are responsible for bringing personal equipment for training, such as
warm and functional clothing and footwear, water, head torches, and any other
training or medical equipment you regularly use when active;
• You are responsible for alerting me if there is anything that I should know
about your health and safety while training with me. For example, if you do
not feel comfortable completing a certain prescribed exercise due to the level
of natural light we are training in, you need to let me know so I can give an
alternative;
• You are aware that there are heavy pieces of equipment in the RBT Studio and to move with caution when training and to be aware of your surroundings whilst in the studio.
• This declaration is in addition to the terms and conditions contained in the
following pages on the Result Based Training Membership Application.
As always, I’m happy to talk over any questions or concerns you might have
at any time.
*
GENERAL TERMS AND CONDITIONS
Below are the terms which apply to all Participants upon signing the Results
Based Training (RBT) Membership Application Form
1. AGE
There is no age limit. Members under 14 years of age must be accompanied by a
parent or guardian properly authorised to agree to these Terms and Conditions
and sign a Membership Application on their behalf.
2. BOOKING AND PAYMENTS
All members must set up their automatic payments (AP) to the RBT bank
account from the date of signing this Membership Application. The GROUP membership
options are:
Unlimited - $33 Weekly AP
x3 week - $28 weekly AP
x2 week - $23 weekly AP
x1 week - $13 weekly AP
Casual $15 per session

RBT Personal Training Sessions options are:
Note: All PTC must set up their automatic payments, make session AP to the RBT bank account.
3o min - $40
45 min - $55
Program change - $75
Group 2-4 $25 each

Note: All PTC must book in with the RBT trainer in advance of all sessions. Session cancellation must be 12 hours prior to allocated booking, failure to do so will result in full session payment.
Payment is to be made into the RBT bank account in advance of each week:
Results Based Training
03 0374 0270267 00
Aps will continue until membership is cancelled by the member. Membership can
be cancelled any time by providing one weeks’ notice to RBT in writing and will
be effective from the date such notification is received. There is no refund for any
amount already paid.
It is each member’s responsibility to keep their funds in a position to be able to
service the AP, and to pay all associated bank fees. If any AP fails, the member will
be given notice and required to settle the balance.
Any unpaid balance exceeding four weeks may be referred to a debt collection
agency, and any associated costs with the recouping of an unpaid balance will be
allocated to that member.
All members must book in with the RBT trainer in advance of all sessions. Sessions
are booked either by:
Regular Booking: members designate in advance what sessions they will attend;
Ad Hoc Booking; members must text the RBT trainer by 9pm for morning sessions
and 12/30pm for evening sessions.
Non-attendance at training session/s will not result in any refund of the training
fees. Members are liable for all training fees irrespective of attendance and
irrespective of any reason for non-attendance at any training session.
RBT will endeavour not to cancel a confirmed booking; however RBT reserves
the right to do so. If RBT cancels a confirmed booking we will offer the member a
full refund. Any cancellation will be sent by written notice to the individual’s last
known phone number or email address.
3. PHYSICAL CONDITION AND MEDICAL ADVICE
All members must be in good physical condition and have no medical reason
or impairment that might prevent their intended participation in the training
session. If member has any health or medical concerns prior to or while attending
training, it is their responsibility to discuss any concerns with a doctor before
attending any training session.
All members must sign the Risk Declaration before commencing training.
4. TRAINING RULES
Members must at all times while they are attending training: (i) follow the
instructions and advice of the RBT trainer; (ii) act with courtesy and respect
towards the RBT trainer and other attendees and refrain from any offensive or
annoying behaviour which may detract from other attendees’ enjoyment of
the training; (iii) immediately inform the RBT trainer if they are suffering any
discomfort or feeling unwell, or are not coping with the technical, physical or
mental demands of the training, or if they notice any other member who appears
to be in discomfort or who are not coping; (iv) immediately inform the RBT trainer
if their health or fitness circumstances change from those previously notified.
Any non-compliance with the terms and conditions set out in this Agreement,
or for any other reason at the sole discretion of RBT, may result in the RBT
trainer requiring member to immediately leave a training session or their RBT
membership. All members undertake to immediately leave if requested to do so.
5. ADVERTISING AND PUBLICITY
Sometimes RBT may photograph a training session for use in promotional and
other business related material. It is possible that, as a member, you may appear in
a photograph. If you do not want your image to be used, it is your responsibility to
advise RBT in writing of this.
6. LIABILITY
Notwithstanding anything else contained in these Terms and Conditions or the
Membership Application, to the fullest extent permitted by law, RBT (including
RBT’s officers and/or its employees) does not have any liability whatsoever to the
member or any other person for any claims, losses, expenses that may have been
incurred by a member or any other party either during, or in any way related to,
a member’s participation in the training sesion, including (but not limited to) any
liability for:
• personal injury or death;
• property loss or damage;
• disruption to travel plans;
• acts which may be negligent or accidental;
• any mental injury or any other loss, damage, suffering, emotional or nervous
disorder;
• any direct, indirect or consequential loss or damage of any kind including any
financial loss.
Laura Ecclestone
Results Based Training

*