Questionnaire, Consent Form, and Payment

Back to Individualized Exercise Programs

Read the Consent Form, Answer the Questionnaire and Click Submit

Please read the following statement and agree to the terms otherwise you will not be sent an exercise program.
I agree and consent to the following:

I am voluntarily participating in an Exercise First, LLC, individualized exercise program. I recognize that the program requires physical exertion that may be strenuous at times and may cause physical injury and I am fully aware of the risks and hazards involved. I understand that it is my responsibility to consult with a physician prior to and regarding my participation in the above mentioned program. I represent and warrant that I have no medical condition that would prevent my participation in the program. I agree to assume full responsibility for any risks, injuries or damage known or unknown which I might incur as a result of participating in the program. Such injuries may include, but are not limited to, heart attacks, muscle strains, muscle pulls, muscle tears, broken bones, shin splints, heat prostration, injuries to knees, injuries to back, injuries to foot, or any other illness or soreness, including death. Exercise First, LLC, is not liable for any of the risks or injuries previously mentioned.

I knowingly, voluntarily and expressly waive any claim I may have against Exercise First, LLC,for any injury or damages that I may sustain as a result of participating in the program. I, my heirs or representatives forever release waive, discharge and covenant not to sue Exercise First, LLC, for any injury or death caused by their negligence or other acts. I have read the above waiver and release of liability and fully understand it contents. I voluntarily agree to the terms and conditions stated above.

After you press submit, click on the Buy Now button below to make your $50 payment

Buy Now Button with Credit Cards

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By clicking the Buy Now button below you will be redirected to a secure website where you will submit your credit card information.You need to consult your physician before starting any exercise program. You are responsible for obtaining a spotter when necessary, and Exercise First, LLC, is not responsible for any possible injury obtained while performing this exercise program. Your questionnaire, payment, and liability form all need to be processed before you receive your program. Make sure you use the same name for all three forms otherwise a file can not be made for you, and you will not receive your program. If your credit card contains a different name make note of that in the description section in PayPal. Your month starts once you receive your program. When you submit your answers, a your file will be created for record keeping. Once the payment is processed and liability form is submitted, you will receive your program within 2-3 days. At the end of the month, send the completed program (with what you were able to do) back and you will receive your next month’s program.You will be charged monthly for your program and can cancel this service at any time (through email: Each month your program will be modified so that you will continue to see success.


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