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Form 1 of 5
Client Intake Form
MEDICAL BACKGROUND: Please check if you have had or currently do have any of the following:

Admission fee for this course is $10

 

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Form 2 of 5
Health and Fitness Questionnaire:
Check which apply to your lifestyle:

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Form 3 of 5
Liability Waiver

I,                                                                              , hereby agree to participate in the health and fitness program given to me by Thrive / Lisa Huck with the express understanding that:

 

1. I acknowledge that I have been advised to consult my personal physician and am physically capable of participation without injury.

 

2. I understand that the reaction of the heart, lung, and blood vessel system to such exercise cannot always be predicted with accuracy. I know there is a risk of certain abnormal changes occurring during or following exercise, which may include abnormalities of blood pressure or heart rate, ineffective functioning of the heart, and in rare instances, heart attacks. Use of weight lifting equipment, and engaging in heavy body calisthenics, can lead to musculoskeletal strains, pain, and injury if adequate warm-up, gradual progression, and safety procedures are not followed. Safety will be emphasized at all times.

 

3. I understand that I have the final responsibility to judge whether something feels “good”, safe, and correct. My feedback is critical in guiding my trainer to deliver the most effective, efficient and safe exercise plan and lifestyle recommendations for me. If I feel any “bad” pain (pains that indicate injury or anticipation of injury), any “red flags”, any anxiety or fear, anything that does not feel right or good for my body, I will report it to my trainer at first reception so that we can stop and make adjustments for safety, effectiveness and efficiency. Again, safety is of the utmost priority. Feedback after the session and regarding any suggestion made in my wellness plan is also critical to continue safety, effectiveness and efficiency.

 

4. I understand, in the case of a nutritional / eating consultation, that the consultant is not a registered dietician and will in no way prescribe special diets for medical conditions. The nutritional information and/or eating coaching that will be given will remain in the scope of recommendations for balanced eating techniques.

 

5. I have read the foregoing information and understand it. Any questions, which may have occurred to me, have been answered to my satisfaction. I understand that I am free to withdraw from this program without prejudice at any time I desire. I am also free to decline answering specific items or questions during interviews or when filling out questionnaires. The information which is obtained will be treated as privileged and confidential and will not be released or revealed to any person other than my physician without my written consent. The information obtained, however, may be used for a statistical or scientific purpose with my right of privacy retained.

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Form 4 of 5
THRIVE FNL, A Private Ministerial Association
Membership Agreement

By joining Thrive FNL, a Private Membership Association and/or any website or Social Media Group started by, created by, maintained, or organized by the Association, I agree to the terms and conditions of Thrive FNL, a Private Membership Association, Agreement as follows.

1. This Association of members declares that our objective is to allow the Private Membership Association founders and all Private Membership Association members with a platform in which to conduct all manner of private business with the Association and with other Associations and Association members, keeping all business in the private domain and utilizing the protections guaranteed by the Universal Declaration of Human Rights (UDHR), the Constitution to conduct business in private and to provide a platform for members to conduct business in the private domain under all protections acknowledged and guaranteed by the Constitution of the UNITED STATES, and any previous protections guaranteed.

2. We believe that the Holy Scriptures, the Universal Declaration of Human Rights (UDHR), the Constitution of the United States of America, the various constitutions of the several states of the union, and the Charter of Rights of Canada guarantees our members the rights of absolute freedom of religion, free speech, petition, assembly, and the right to gather together for the lawful purpose of helping one another in asserting our rights protected by those Constitutions, Charter and Statutes, in addition to the rights to be free from unreasonable search and seizure, the right to not incriminate ourselves, and the right to freely exercise all other unalienable rights as granted by our creator, our almighty God and guaranteed by those Constitutions, Charter, and Statutes. 
WE HEREBY Declare that we are exercising our right of “freedom of association” as guaranteed by the Universal Declaration of Human Rights (UDHR), the U.S. Constitution and equivalent provisions of the various State Constitutions, as well as the Charter of Rights of Canada. This means that our Association activities are restricted to the private domain only and outside of the jurisdiction of government entities, agencies, officers, agents, contractors, and other representatives as provided by law.

3. We declare the basic right of all our members to decide for themselves which Association members could be expected to give wise counsel and advice concerning all matters including, but not limited to education, physical, spiritual, and mental health care assistance, law, and any other matter and to accept from those members any and all counsel, advice, tips, whom we feel are able to properly advise and assist us.

4. We expect the freedom to choose and perform for ourselves the types of therapies and treatments that we think best for diagnosing, treating, and preventing illness and disease and for achieving and maintaining optimum wellness, as well as the freedom to choose for ourselves any types of assistance which may be made regarding law and any other private business activity.

5. The mission of this Association is to provide members with a forum to conduct business between members in the private domain with the protections guaranteed within the aforesaid Constitution and Charter remaining fully intact. 

6. The Association will recognize any person(s), natural or otherwise (irrespective of race, color, or religion) who have joined this Association or any social media group organized, created, or managed by this Association and is in agreement with these principles and policies as a member of this Association, providing said person has not been sanctioned, exercised, or otherwise banned by the association, and will provide a medium through which its individual members may associate for actuating and bringing to fruition the purposes heretofore declared.

 

7. Membership to this Association, "Thrive FNL", and any of its groups may be terminated by the association Trustees or their designee, at any time, should they conclude that a specific member is interacting with them or any other members in a way that is contrary or detrimental to the focus, principles, and betterment of this Association.

 

8. I understand that, since The Association is protected by the First and Fourteenth Amendments to the U.S. Constitution, it is outside the jurisdiction and authority of Federal and State Agencies and Authorities concerning any and all complaints or grievances against The Association members or other staff persons. All rights of complaints or grievances will be settled by an Association designee, committee, or tribunal and will be waived by the member for the benefit of The Association and its members. By agreeing to this membership form I agree that I have sought sufficient education to determine that this is the course of action I want to take for myself.

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9. I agree to join Thrive FNL, a private membership association under common law, whose members seek to help each other achieve better health and good quality of life. I am voluntarily changing my capacity from that of a public person to that of a private member.

My activities within The Association are a private contractual matter that I refuse to share with the Local, State, or Federal investigative or enforcement agencies. I fully agree not to pursue any course of legal action against a fellow member of The Association, unless that member has exposed me to a clear and present danger of substantive evil, and upon the recommendation and approval of the Association.

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10. I enter into this agreement of my own free will without any pressure or coercion. I affirm that I do not represent any Local, State or Federal agency whose purpose is to regulate and approve products or services, or to carry out any mission of enforcement, entrapment or investigation. I have read and understood this document, and my questions have been answered fully to my satisfaction. I understand that I can withdraw from this agreement and terminate my membership in this association at any time, and that my membership can and will be revoked if I engage in abusive, violent, menacing, destructive or harassing behavior towards any other member of The Association. These pages consist of the entire agreement for my membership in The Association.


I agree this contract began on the date of my joining "Thrive FNL". I declare that by joining this Association and/or the Associations websites and/or social media group(s), I have carefully read the whole of this document and I understand and agree with it.

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Form 5 of 5
Policies & Procedures

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1. Fees: The fee is $215 per hour per session In-Office ($360/hour for Offsite Sessions. Driving time billed at the same rate), unless otherwise noted. The fees are pre-paid at the first session of the month (see details below) for that month in the occasion of reoccurring session and due at the time of service in single sessions. On occasion, there will be behind the scenes work (for example: strategic planning, research and write-ups): Office time for this is billed at the same rate. I will let you know before any of this is done. Fees are non-refundable, non-transferable and expire if not used within 12 months of being paid.

 

2. Scheduling/Billing: In the case of recurring sessions that are being reserved for you...in the last week of the month a schedule for the next month will be proposed, usually by email or text. You can let me know which appointments fit and any adjustments you need. On the first session of the month you pay by cash, electronic means (i.e. Venmo or other platforms that we can decide upon) or check made to “Thrive FNL” for the number of sessions we decided on. If you would like an invoice at the end of the year (or more frequently) it is available upon request.

 

3. Cancellation/Reschedule Policy: There is a 48-hour notice to cancel or reschedule a session or

the fee is forfeited.

 

4. Other suggestions:

a. Please bring a towel and water to the session as well as wear close-heeled shoes.

b. Once you’ve learned and are confident doing the stretches I will ask that you arrive early to do the prep work so that the time I have with you can be most efficient, effective and used to progressing your fitness.

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5. Small Group Personal Training, Classes and Offsite Session Policies:


a. Fees for Partnered Sessions, Small Group Personal Training Sessions, Classes and/or Offsite Sessions serve as a
reservation fee to reserve your time slot for the month and are non-refundable and non- transferable to other time period or other participants. There are no make-ups if you miss a class whether planned or at the last minute.
b. Fees are paid for by the first day of class for the month of classes/sessions.

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