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Integrative Health Coaching | Membership Agreement
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Service & Membership Selection
1 per Month ($55 every 1 Month, Auto-Renews)
Every Other Week ($100 every 1 Month, Auto-Renews)
1 per Week ($150 every 1 Month, Auto-Renews)
Other (One Session, Free Consult)
I understand that a 30 day cancellation notice is required to terminate my membership. Memberships auto-renew monthly on their designated renewal date. Unused sessions do not roll over from month to month.
Yes, I understand.
I agree. [Initials Needed]
I am committed to my own personal health and wellness.
With this commitment, I give my word to:
Be open to new foods, concepts, and exercises
Fulfill the commitments I make
Eat nourishing foods according to the guidance of my Health Coach & Other Care Providers
Exercise according to the guidance of my Health Coach & Other Care Providers
Find a healthy balance between work and play
Give gratitude in the relationships in my life
Develop a listening to my body’s wants and needs
Powerfully deal with the stressors in my life
Begin and end our sessions on time
Each session will end 50 minutes after it was scheduled to begin. Please be on time. The Client will forfeit the session if arrival is 15 minutes late or more. If the Client needs to reschedule the appointment, the Client must do so 24 hours in advance (subject to availability). Refunds are not provided for any reason. [Electronic Signature Needed]
Liability Agreement & Waiver
The Client understands that the role of Latitude 44 Yoga Studio, and the Health Coach is not to prescribe or assess micro- and macronutrient levels; provide health care, medical or nutrition therapy services; or to diagnose, treat or cure any disease, condition or other physical or mental ailment of the human body. Rather, the Coach is a mentor and guide who has been trained in holistic health coaching to help clients reach their own health goals by helping clients devise and implement positive, sustainable lifestyle changes. The Client understands that the Coach is not acting in the capacity of a doctor, licensed dietician-nutritionist, psychologist or other licensed or registered professional, and that any advice given by the Coach is not meant to take the place of advice by these professionals. The Client should discuss any dietary changes or potential dietary supplement use with his or her care provider, and should not discontinue any prescription medications without first consulting his or her doctor. The Client has chosen to work with the Coach and understands that the information received should not be seen as medical or nursing advice and is not meant to take the place of seeing licensed health professionals. I recognize that the Integrative Health Coaching sessions with Latitude 44 Yoga Studio, LLC is strictly for entertainment purposes. The topics discussed are not to be used as a form of medical treatment or care plan. I assume full responsibility for personal decisions, and further release and discharge Latitude 44 Yoga Studio of any liability. I agree to indemnify and defend Latitude 44 Yoga Studio against all claims, causes of action, damages, judgments, costs or expenses, including attorney fees and other litigation costs. I agree to pay for all damages to the facilities caused by my negligent, reckless, or willful actions. I agree and acknowledge that I am under no pressure or duress to sign this Agreement and that I have been given reasonable opportunity to review it before signing. I further agree and acknowledge that Latitude 44 Yoga Studio has offered to refund any fees I have paid to use its facilities if I choose not to sign this Agreement. I understand that the cancellation policy is 24 hours for scheduled Integrative Health Coaching, and 30 days for the auto-renewing membership and no refunds will be provided. I have read this information and understand it. I further understand that by signing this release, I voluntarily surrender certain legal rights. [Electronic Signature Needed]
313 E. Madison Street
Eau Claire, Wisconsin 54703
Studio: (715) 828-3936
Latitude 44 Yoga Studio, LLC