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Client(s)’s Full Name:

Date of Birth:
Street Address:
City, State, Zip:
Home Phone:
Cell Phone:
Work Phone:

I __________________________________________ (full name) (henceforth known as Client(s)) hereby

agree to accept and be legally bound by this Omega 3 Health Ministry(O3HM) Contract.

• Client(s) must be currently authorized by their Physician in order to participate in this or in any other
Omega 3 Boot Camp(O3BC) or Regimen with the Omega 3 Health Ministry.
• Client(s) will be required to complete the proper documentation prior to participation within the O3BC
• Programs.
• Omega 3 Heath Ministry’s reserves the right to deny services to participants who may not be able to
exercise safely within the program parameters as may be determined by Physicians report.

CONDUCT OF Omega 3 Boot Camp(O3BC)

• Client(s) must wear proper attire (i.e. shorts, sweat pants, t-shirt, tennis/running shoes, etc.) Absolutely no
jeans, jean shorts, sandals, open toe shoes of any kind.
• Omega 3 Boot Camp(s) will be conducted at a location as agreed upon by O3HM and Client(s).
• Omega 3 Boot Camp(s) will be a maximum of 60 minutes in length.
• Omega 3 Boot Camp(s) must be conducted/completed on the day(s) agreed upon by O3HM and Client(s).

I have enrolled in a program of strenuous physical activity including, but not limited to walking, running,
boxing, dance, kickboxing, weight lifting, step aerobics, aerobics, body sculpting and the use of various
conditioning and exercise equipment and facilities designed, offered, recommended, and/or supervised by
Temple Builder’s Organization. I hereby affirm that I am in good physical condition and do not suffer from any
disability that would prevent or limit my participation in this program.

In consideration of my participation in O3BC Program 1, I for myself, my employees, heirs, assigns, agents,
officers, directors, shareholders and co-workers hereby release Omega 3 Health Ministry, its employees,
spouse, re latives, heirs, assigns, agents, officers, d irectors, and s hareholders, fr om any and al l claims,
demands or causes of action arising from my participation in O3BC Program 1 or from any use of the
conditioning and exercise equipment and facilities.

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I fu lly u nderstand that I may s uffer i njury as a result o f m y participation i n O 3BC Program 1 and I h ereby
release O mega 3 Health M inistry from an y an d all l iability n ow or i n t he fu ture, i ncluding but n ot l imited to
medical expenses, lost wages, pain and suffering, that may occur by reason of heart attacks, muscle strains,
pulls or tears, broken bones, shin splints, heat prostration, knee/lower back/foot injuries, and any other illness,
soreness, or injury, however caused, whether occurring during or after my participation in the program or use
of the conditioning and exercise equipment and facilities, regardless of fault.


I acknowledge and agree that this O3HM Contract is not transferable or assignable. I acknowledge that
payment is required in advance of actual workout session(s). I understand this money is non
refundable. I acknowledge that this specific contract, release of liability, consent, and agreement is
continuously valid indefinitely. I understand that fitness building session(s) purchased must be completed on
the day(s) agreed upon by Omega 3 Health Ministry and Client(s) and NO refund will be granted for session(s)
that have not been completed. I understand O3HM has the right and the authority to terminate the program at
any time, with no refund, if I do not follow the program or fail to conduct myself in an appropriate manner.

The O3BC Program 1 price is $250 per 12 weeks( 2 days a week). I understand that payment for the boot camp
program and any other fees that may occur, will be collected at the time of registration and paid directly to the
Omega 3 Healthy Ministry prior to my participation.

There will be a $25 charge on all returned checks.

By signing this document, I attest, contract, acknowledge, and agree that I am legally bound by its content.

________________________________ _________________
Client(s) Signature Date

________________________________ _________________
Omega 3 Health Ministry Authorized Signature Date

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