Please download the MBG waiver (pdf is linked above) and fill out in entirely before coming in for your first session. This will help us tailor our coaching to your goals.
Please download and fill out the ParMedX form.
Personal training cancellation policy:
24 hours notice of cancellation required, or appointment chargeable at full rate.
Show up ready to sweat!
- Leave happy, rejuvenated and ready to take on the world.
ACKNOWLEDGEMENTS AND WAIVER & RELEASE OF LIABILITY
Kathleen Neilson and Simon Young d/b/a Monkey Bar Gym Vancouver Island ("MBGVI")
Member/Client (hereinafter "Client"). Client agrees, in addition to the terms and conditions of their written agreement with Kathleen Neilson and Simon Young d/b/a Monkey Bar Gym Vancouver Island to be bound by the following Terms and Conditions of Service.
Client acknowledges that seeking a doctor’s approval before beginning any health/fitness/nutrition program is good practice. The purpose of Kathleen Neilson and Simon Young d/b/a Monkey Bar Gym Vancouver Island (the "club") is to provide fitness instruction and coaching for various levels of athletes/individuals. Clients acknowledge that the following was explained to me and agrees as follows:
1. Acknowledges that Kathleen Neilson, Simon Young or any of their staff members employed at the club are not physicians and are not trained in any way to provide medical diagnosis, medical treatment, or any other type of medical advice.
2. Acknowledges that coaching/training is another tool for teaching athletes/individuals about themselves, but that the club does not guarantee neither good nor bad will occur nor guarantees the training advice given by club staff and/or instructors will produce good nor bad results.
3. Acknowledges that the undersigned has been told if they feel tired, feel pain or feel out of the ordinary in any way either related to your training, or otherwise, that the undersigned should contact a physician immediately.
4. Acknowledges that boot camps, aerobic classes, martial arts, self-defense, boxing, krav maga, muay thai, kick boxing, running, kung-fu, weight training, obstacle courses, and any other related sports are an extreme test of one's mental and physical limits and carry with it potential for damage or loss of property, serious injury and death. That the undersigned assumes the risks of participating in these types of events/activities including the elements of a natural environment, that they are fit, and they have a regular medical physician they can contact regarding any medical problems that they might develop.
WAIVER AND RELEASE OF LIABILITY. Please read this carefully and be aware that, in electronically signing, you will be waiving and releasing all claims for injuries, including death, that you might sustain arising out of the use of the club or participation in MBGVI fitness programs and/or exercise classes.
I, the undersigned, by electronically signing the Monkey Bar Gym Vancouver Island Registration form, do hereby acknowledge and agree to release Kathleen Neilson and Simon Young d/b/a Monkey Bar Gym Vancouver Island ("MBGVI") and all MBGVI owners, agents, employees and representatives from any and all claims for injuries that may arise out of or are associated with my use of the MBGVI facilities or participation in MBGVI fitness programs and/or exercise classes.
I am aware that there are risks associated with the use of the MBGVI facilities and agree and understand that I am assuming the risks associated with the use of the MBGVI facilities and all equipment contained therein, and participation in MBGVI fitness programs and/or exercise classes including the risk of injury and death.
I HEREBY RELEASE, WAIVE AND RELINQUISH ANY AND ALL CLAIMS THAT I MAY HAVE AGAINST KATHLEEN NEILSON AND SIMON YOUNG D/B/A MONKEY BAR GYM VANCOUVER ISLAND ("MBGVI") AND ITS DIRECTORS, OFFICERS, OWNERS, AGENTS, SERVANTS, REPRESENTATIVES AND EMPLOYEES AS A RESULT OF MY USE OF THE MBGVI FACILITIES OR MY PARTICIPATION IN MBGVI FITNESS PROGRAMS AND/OR EXERCISE CLASSES, INCLUDING ANY CLAIMS FOR NEGLIGENCE, BUT NOT INCLUDING CLAIMS FOR ANY INTENTIONAL OR RECKLESS ACTS. I DO HEREBY FULLY RELEASE AND DISCHARGE KATHLEEN NEILSON AND SIMON YOUNG D/B/A MONKEY BAR GYM VANCOUVER ISLAND ("MBGVI") AND ITS DIRECTORS, OFFICERS, OWNERS, AGENTS, REPRESENTATIVES, SERVANTS AND EMPLOYEES FROM ANY AND ALL CLAIMS FROM INJURIES ARISING OUT OF OR ASSOCIATED WITH THE USE OF THE MBGVI FACILITIES OR PARTICIPATION IN MBGVI FITNESS PROGRAMS AND/OR EXERCISE CLASSES, INCLUDING DEATH, DAMAGE OR LOSS WHICH I MAY HAVE OR WHICH MAY ACCRUE TO ME ON ACCOUNT OF MY USE OF THE MBGVI FACILITIES OR PARTICIPATION IN MBGVI FITNESS PROGRAMS AND/OR EXERCISE CLASSES, INCLUDING ALL CLAIMS FOR NEGLIGENCE ON THE PART OF KATHLEEN NEILSON AND SIMON YOUNG D/B/A MONKEY BAR GYM VANCOUVER ISLAND ("MBGVI") IN CONNECTION THEREWITH BUT NOT INCLUDING CLAIMS FOR ANY INTENTIONAL OR RECKLESS ACTS.
I have read and fully understand the aforementioned Waiver and Release of Liability. I have considered that, if this Waiver and Release of Liability was not as broad as it is, the cost for my use of the MBGVI facilities or participation in MBGVI fitness programs and/or exercise classes would be considerably higher, and as I do not wish to pay a considerably higher cost, I waive the right to bargain for different terms for this Waiver and Release of Liability.
TERMS & CONDITIONS OF SERVICE
Kathleen Neilson and Simon Young d/b/a Monkey Bar Gym Vancouver Island ("MBGVI")
By electronically signing the Monkey Bar Gym Vancouver Island Registration Form you agree to the the terms and conditions of our service. And acknowledge and agree that any future purchase of our services would be based on your acknowledged agreement to these terms and conditions.
SALES & MEMBERSHIP POLICY. Notwithstanding any other provisions of this Agreement, you understand and agree that the amount of your monthly membership dues is based on current sales tax rates and to the extent such rates should increase during your membership, the club has the right to increase your monthly membership dues by the amount of such increase. If you have requested the privilege of paying your monthly dues by preauthorized electronic funds transfer, the monthly amount so transferred will be adjusted to reflect any increase in the sales tax rate.
DEFAULT AND LATE PAYMENTS. Should you default on any payment obligation as called for in this Agreement, the club will have the right to declare the entire remaining balance due and payable and you agree to pay allowable interest, and all costs of collection, including but not limited to collection agency fees, court costs, and attorney fees. A default occurs when any payment due under this Agreement is more than ten days late. Should any monthly payment become more than ten days past due, you will be charged a late fee. An additional service fee will be assessed for any check, draft, credit card, or order returned for insufficient funds or any other reason. If the Member is paying monthly dues by electronic funds transfer (EFT), the club’s billing company, Mind Body Online, Inc., reserves the right to draft via EFT all amounts owed by the member including any and all late fees and service fees. Subject to the laws of British Columbia. NOTE: Members paying monthly dues by EFT are subject to $5.00 per month increase of monthly dues if EFT payment is stopped or changed. This will not affect any other provisions of this Agreement.
NOTICE. ANY HOLDER OF THIS AGREEMENT IS SUBJECT TO ALL CLAIMS AND DEFENSES WHICH THE DEBTOR COULD ASSERT AGAINST THE SELLER OF GOODS OR SERVICES OBTAINED. PURSUANT HERETO OR WITH THE PROCEEDS HEREOF, RECOVERY HEREUNDER BY THE DEBTOR SHALL NOT EXCEED AMOUNTS PAID BY THE DEBTOR HEREUNDER.
CANCELLATION AND REFUNDS. Right to Cancel. You are permitted to cancel this Agreement until midnight of the 3rd operating day after the date on which you signed the contract. If the facilities or services that are described in the contract are not available at the time you sign the contract, you have until midnight of the 3rd operating day on which you received notice of their availability to cancel the contract. If within this time period you decide you want to cancel this contract, you may do so by notifying MBGVI by any writing mailed or delivered to MBGVI at the address shown on the contract, within the previously described time period. If you do so cancel, any payments made by you, less a user fee of no more than $3 per day of actual use, will be refunded within 21 days after notice of cancellation is delivered, and any evidence of any indebtedness executed by you will be canceled by MBGVI and arrangements will be made to relieve you of any further obligation to pay the same. If any of the services described herein become unavailable or are no longer fully operational, before full receipt of the services and use of the facilities for which you contracted, you are liable only for that portion of the total consideration proportional to the elapsed time portion of the contract at the time of the unavailability. You are entitled to a refund of any other funds already paid. You have the option, in lieu of the proportional refund described above, to choose to complete the unused portion of the term of this Agreement including any renewal periods at the price disclosed in this Agreement at another location which is owned, controlled, affiliated with or operated by MBGVI. Any modification of this Agreement must be made in writing and may only modify the terms of the Agreement concerning the unavailable or no longer fully operational facilities or services.
THIS NOTICE PROVIDES IMPORTANT INFORMATION ABOUT YOUR PAYMENT OPTIONS
You may make payments on an installment basis or in a single payment. Paying the full amount may be less expensive, but may involve financial risks to you. Read this notice carefully before making a decision.
Memberships are non-refundable.
ADDITIONAL RIGHTS TO CANCELLATION. If upon a doctor’s order, you cannot physically receive the services because of significant physical disability for a period in excess of six months. If you die, your estate shall be relieved of any further obligation for payment under the contract not then due and owing. If you move your residence more than two hundred and fifty miles from any location operated by MBGVI. If the services cease to be offered as stated in the contract. All moneys paid pursuant to such contract cancelled for the reasons contained in this subdivision shall be refunded within fifteen days of receipt of such notice of cancellation; provided however that MBGVI may retain the expenses incurred and the portion of the total price representing the services used or completed, and further provided that MBGVI may demand the reasonable cost of goods and services which the MEMBER has consumed or wishes to retain after cancellation of the contract. In no instance shall MBGVI demand more than the full contract price from the MEMBER. If the MEMBER has executed any credit or loan Agreement to pay for all or part of health club services, any such negotiable instrument executed by the MEMBER shall also be returned within fifteen days.
EARLY CANCELLATION. Any early cancellation of a membership agreement you purchase from Kathleen Neilson and Simon Young d/b/a Monkey Bar Gym Vancouver Island ("MBGVI") is subject to a $250.00 cancellation fee. Any early cancellation of this Agreement must be submitted in writing to MBGVI management 30 days prior to the next scheduled membership payment. Any payment within your 30 day notice to cancel is required to be paid in order to fulfill your membership cancellation. Absent any provision in this Agreement to the contrary, if you wish to cancel during the term of this Agreement, you shall be required to pay a $250.00 early termination fee, and shall be current on all other amounts owed under the terms of this Agreement.
FREEZES. If you wish to freeze or suspend your membership, you may do so for a period of no less than one month and no more than three months during the term of this Agreement. If you wish to freeze your membership you must provide 30 days advanced notice prior to the start of the freeze, and shall pay a $150.00 fee if the freeze is unrelated to a diagnosed injury or medical condition that prevents you from engaging in the services offered under this Agreement, or is without MBGVI management approval.
TRANSFERS. You may transfer your membership upon written MBGVI management approval for a fee of $75.00.
ELECTRONIC FUNDS TRANSFER (EFT). Membership services can be paid in full or through electronic funds transfer (EFT) via checking/savings account or credit card.
DEACTIVATION. Failed auto payments over 30 days will result in a deactivation of your membership and your account. A reactivation fee of $75.00 will apply to resume membership.