# Informed consent & assumption of risk — draft for review

> **Not ready for client use until reviewed.** This is a generic template, not legal advice or a guarantee that any release is enforceable. Ask your professional-liability insurer and a California attorney to tailor and approve it. California law limits what can be waived; this form is not intended to waive gross negligence, reckless conduct, intentional harm, or any right that cannot legally be waived. Use a lawyer-drafted version if the insurer provides one.

**Trainer:** Yury Shirokov  
**Client:** __________________________________________  
**Effective date:** __________________

## Services

I understand the trainer provides fitness instruction and general exercise programming within the trainer’s certification and professional scope. The trainer does not diagnose or treat medical conditions, provide physical therapy, or replace advice from my physician or other licensed health professional. Any general nutrition discussion is educational and does not replace individualized medical nutrition care.

## Health screening and communication

I have completed the trainer’s intake and current pre-participation screening truthfully. I will tell the trainer about relevant changes to my health, medications, symptoms, or exercise restrictions before participating. I will seek guidance or medical clearance when the screening tool or my health professional recommends it. The trainer may decline, stop, or modify a session when safety concerns arise.

## Voluntary participation and risks

I choose to participate voluntarily. I understand exercise carries inherent risks, including muscle soreness, strains, sprains, falls, fainting, abnormal blood pressure or heart responses, and, rarely, serious injury or death. Risks can arise from exercise itself, equipment, the training environment, or my own health and actions. I agree to follow instructions, use equipment as directed, and stop and tell the trainer if I experience pain, dizziness, unusual shortness of breath, or other concerning symptoms.

## Equipment and setting

For in-person training, I will provide a reasonably safe training space and tell the trainer about hazards, pets, access limitations, or relevant conditions. I understand portable equipment may be used and will inspect it with the trainer before use. For online sessions, I am responsible for a clear, safe exercise area, a stable internet connection, and safe setup and use of my equipment. Online coaching cannot provide hands-on spotting or emergency response at my location.

## Emergency response

If an emergency occurs, I authorize the trainer to contact emergency services and my listed emergency contact when reasonably appropriate. I understand I am responsible for my own medical expenses and should maintain appropriate health coverage.

## Release limited by applicable law

To the fullest extent permitted by applicable law, I accept the ordinary and inherent risks of voluntary exercise and release the trainer from claims arising from those inherent risks, except for claims based on gross negligence, reckless or intentional misconduct, or any other liability that cannot legally be released. Nothing in this document removes rights that applicable law does not allow me to waive.

## Acknowledgment

I have had the opportunity to ask questions, understand that participation is voluntary, and understand this document before signing. I am at least 18 years old.

Client name (print): __________________________________________

Client signature: _____________________________________________ Date: ______________

Trainer signature: ____________________________________________ Date: ______________

Emergency contact name/phone recorded on separate intake: ☐ Yes