Virtu-Fit®

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Prior to commencing exercise program, please complete the health questionnaire below in detail.

*Release Disclaimer: Pre-paid programs do not offer refunds or makeup classes. Any technical or other reason for a missed class and any cancellation or postponement of the scheduled sessions will be charged. I understand that fitness activities involve a risk of injury and assume the full risk of and release Marc D. Thompson from any liability. I do hereby further declare myself to be physically sound to participate in exercises or use of equipment or machinery. ½ hour sessions average about 27 minutes; 1-hour sessions average about 55 minutes. Hour sessions and house calls are double the rates listed. Additional $10 fee per session for check/money order/card.

14 + 3 =

Marc D. Thompson, VPT
INTEGRATED HEALTH & WELLNESS SERVICES
m@arcifc.com

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