Training Session Sign-Up *If you have already filled out this form, click here Schedule Athlete's Name * First Name Last Name Parent's Name First Name Last Name Email * Phone * (###) ### #### Grade * 8th 9th 10th 11th 12th Years of Experience * 1 Year 2 Years 3+ Years Est. Weight * Coaching Agreement * This Agreement is entered into by and between: Mason Miller, M.S., Champion for Life Training LLC (“Coach”) and Client with permission of Client’s Parent/Legal Guardian whereby Coach agrees to provide Coaching Services for Client focusing on Mindset Coaching, Performance Nutrition Guidance, Wrestling Skills/Technique, and Strength & Conditioning. Description of Coaching: Coaching is a partnership (defined as an alliance, not a legal business partnership) between the Coach and the Client in a thought-provoking and creative process that inspires the client to maximize personal and sport-specific potential. It is designed to facilitate the creation/development of personal and sport-specific goals and to develop and carry out a strategy/plan for achieving those goals. 1. Coach-Client Relationship a. Client is solely responsible for creating and implementing his/her own physical, mental and emotional well-being, decisions, choices, actions and results arising out of or resulting from the coaching relationship and his/her coaching communications and interactions with the Coach. As such, the Client agrees that the Coach is not and will not be liable or responsible for any actions or inaction, or for any direct or indirect result of any services provided by the Coach. Client understands coaching is not therapy and does not substitute for therapy if needed, and does not prevent, cure, or treat any mental disorder or medical disease. b. Client further acknowledges that he/she may terminate or discontinue the coaching relationship at any time. c. Client acknowledges that coaching is a comprehensive process that may involve different areas including health, relationships, education, and recreation. The Client agrees that deciding how to handle these issues, incorporate coaching principles into those areas and implementing choices is exclusively the Client’s responsibility. d. Client acknowledges that coaching does not involve the diagnosis or treatment of mental disorders as defined by the American Psychiatric Association and that coaching is not to be used as a substitute for counseling, psychotherapy, psychoanalysis, mental health care, substance abuse treatment, or other professional advice by legal, medical or other qualified professionals and that it is the Client’s exclusive responsibility to seek such independent professional guidance as needed. If Client is currently under the care of a mental health professional, it is recommended that the Client promptly inform the mental health care provider of the nature and extent of the coaching relationship agreed upon by the Client and the Coach. e. The Client understands that in order to enhance the coaching relationship, the Client agrees to communicate honestly, be open to feedback and assistance and to create the time and energy to participate fully in the program. 2. Services a. The parties agree to engage in Coaching Program through in-person meetings, telephone communications, and online meetings to be renewed month-to-month and/or session-to-session at the discretion of the Client. b. Coach will be available to Client by email, voicemail, and text message in between scheduled meetings as defined by the Coach. Coach will attempt to respond within 24 hours to each communication. 3. Schedule, Fees, Refund Policy a. This coaching agreement is valid as of the date of Client and/or Client’s Parent/Legal Guardian signing in agreement. The fee is: i. PLATINUM PACKAGE: $190 USD recurring per month for four times per week meetings consisting of two 60-minute Wrestling Skills/Technique Sessions and two 60-minute Strength & Conditioning Sessions as well as a Performance Nutrition Protocol and one 30-minute Mindset Training Session per week. ii. GOLD PACKAGE: $140 USD recurring per month for two times per week meetings consisting of one 60-minute Wrestling Skills/Technique Sessions and one 60-minute Strength & Conditioning Sessions as well as a Performance Nutrition Protocol and one 30-minute Mindset Training Session per week. iii. MINDSET TRAINING PACKAGE: $120 USD recurring per month for one 30-minute Mindset Training Session per week plus periodic Mindset Training via text messaging and/or email with Coach at discretion of Coach. iv. $45 USD per Stand-Alone 120-Minute Strength & Conditioning and Wrestling Skills Technique Session v. $40 USD per Stand-Alone 60-Minute Wrestling Skills Technique Session vi. $35 USD per Stand-Alone 60-Minute Strength & Conditioning Session vii. $30 USD per Stand-Alone Performance Nutrition Protocol viii. $40 USD per Stand-Alone 30-Minute Mindset Training Session b. If rates change before this agreement has been signed and dated, the prevailing rates will apply. c. The refund policy in effect for this Coaching Agreement is as follows: i. After the Coaching Program has begun, any unused sessions will not be refunded, but may be rescheduled for up to 1 month after the initial payment at the discretion of the Coach. ii. Refunds requested in writing prior to the beginning of the Coaching Program will be given in full. iii. All unused sessions expire 1 month after initial payment. 4. Scheduling & Procedure a. The time of the in-person training meetings will be determined by Coach and Client based on the seasonal training schedule and mutually agreed upon time. All sessions will be held at the Champion for Life Training Center located at 1537 E Euclid Ave Des Moines, IA 50313. The Client will initiate all scheduling communications and call the Coach by telephone or communicate via email. 5. Confidentiality a. Please be aware that the Coach-Client relationship is not considered a legally confidential relationship (like the medical and legal professions) and thus communications are not subject to the protection of any legally recognized privilege. The Coach agrees not to disclose any information pertaining to the Client without the Client’s and Client’s Parent/Guardian’s written consent. The Coach will not disclose the Client’s name as a reference without the Client’s and Client’s Parent/Guardian’s written consent. Confidential Information does not include information that: (a) was in the Coach’s possession prior to its being furnished by the Client; (b) is generally known to the public or in the Client’s industry; (c) is obtained by the Coach from a third party, without breach of any obligation to the Client; (d) is independently developed by the Coach without use of or reference to the Client’s confidential information; or € the Coach is required by statute, lawfully issued subpoena, or by court order to disclose; (f) is disclosed to the Coach and as a result of such disclosure the Coach reasonably believes there to be an imminent or likely risk of danger or harm to the Client or others; and (g) involves illegal activity. The Client also acknowledges his or her continuing obligation to raise any confidentiality questions or concerns with the Coach in a timely manner. 6. Cancellation Policy a. Client agrees that it is the Client's responsibility to notify the Coach 2 hours in advance of the scheduled in-person training meetings. Coach reserves the right to bill Client for a missed meeting. Coach will attempt in good faith to reschedule the missed meeting within the week of the missed training session beginning Sunday and ending Saturday of the given week. 7. Termination a. Either the Client or the Coach may terminate this Coaching Agreement at any time with 1 week written notice. Client agrees to compensate the Coach for all coaching services rendered through and including the effective date of termination of the coaching relationship. 8. Limited Liability a. Except as expressly provided in this Coaching Agreement, the Coach makes no guarantees, representations or warranties of any kind or nature, express or implied with respect to the coaching services negotiated, agreed upon and rendered. In no event shall the Coach be liable to the Client for any indirect, consequential or special damages. Notwithstanding any damages that the Client may incur, the Coach’s entire liability under this Coaching Agreement, and the Client’s exclusive remedy, shall be limited to the amount actually paid by the Client to the Coach under this Coaching Agreement for all coaching services rendered through and including the termination date. 9. Entire Agreement a. This document reflects the entire agreement between the Coach and the Client and reflects a complete understanding of the parties with respect to the subject matter. This Coaching Agreement supersedes all prior written and oral representations. The Coaching Agreement may not be amended, altered or supplemented except in writing signed by both the Coach and the Client. 10. Dispute Resolution a. If a dispute arises out of this Coaching Agreement that cannot be resolved by mutual consent, the Client and Coach agree to attempt to mediate in good faith for up to 30 days after notice given. If the dispute is not so resolved, and in the event of legal action, the prevailing party shall be entitled to recover attorney’s fees and court costs from the other party. 11. Severability a. If any provision of this Coaching Agreement shall be held to be invalid or unenforceable for any reason, the remaining provisions shall continue to be valid and enforceable. If the Court finds that any provision of this Coaching Agreement is invalid or unenforceable, but that by limiting such provision it would become valid and enforceable, then such provision shall be deemed to be written, construed, and enforced as so limited. 12. Waiver a. The failure of either party to enforce any provision of this Coaching Agreement shall not be construed as a waiver or limitation of that party's right to subsequently enforce and compel strict compliance with every provision of this Agreement. 13. Applicable Law a. This Agreement shall be governed and construed in accordance with the laws of the State of Iowa, without giving effect to any conflicts of law’s provisions. 14. Binding Effect a. This Agreement shall be binding upon the parties hereto and their respective successors and permissible assigns. Have you the Client and Client's Parent/Legal Guardian read and agree to these terms? Yes Assumption of Risk, Waiver and Release of Liability, and Indemnity Agreement * DECLARATIONS: This Agreement is entered into between coach/personal trainer Mason Miller, M.S., Champion for Life Training LLC (“Coach/Personal Trainer”) and Client with permission of the Client’s Parent/Legal Guardian. The provision of coaching/personal training services by Coach/Personal Trainer to Client, and Client’s use of any premises, facilities or equipment are contingent upon this Agreement. ASSUMPTION OF RISK: You agree that if you engage in any physical exercise or activity, including personal training and wrestling, or enter our premises or use any facility or equipment on our premises for any purpose, you do so at your own risk and assume the risk of any and all injury and/or damage you may suffer, whether while engaging in physical exercise or not. This includes injury or damage sustained while and/or resulting from using any premises or facility, or using any equipment, whether provided to you by Coach/Personal Trainer or otherwise, including injuries or damages arising out of the negligence of Coach/Personal Trainer, whether active or passive, or any of Coach/Personal Trainer’s affiliates, employees, agents, representatives, successors, and assigns. Your assumption of risk includes, but is not limited to, your use of any exercise equipment (mechanical or otherwise), sports fields, mats, or other areas, locker rooms, restrooms, sidewalks, parking lots, stairs, whirlpools, saunas, steam rooms, lobby or other general areas of any facilities, or any equipment. You assume the risk of your participation in any activity, class, program, instruction, or event, including but not limited to weightlifting, walking, jogging, running, aerobic activities, aquatic activities, wrestling or any other sporting or recreational endeavor. You agree that you are voluntarily participating in the aforementioned activities and assume all risk of injury, illness, damage, or loss to you or your property that might result, including, without limitation, any loss or theft of any personal property, whether arising out of the negligence of Coach/Personal Trainer or otherwise. RELEASE: You agree on behalf of yourself (and all your personal representatives, heirs, executors, administrators, agents, and assigns) to release and discharge Coach/Personal Trainer (and Coach/Personal Trainer’s affiliates, related entities, employees, agents, representatives, successors, and assigns) from any and all claims or causes of action (known or unknown) arising out of the negligence of Coach/Personal Trainer, whether active or passive, or any of Coach/Personal Trainer’s affiliates, employees, agents, representatives, successors, and assigns. This waiver and release of liability includes, without limitation, injuries which may occur as a result of (a) your use of any exercise equipment or facilities which may malfunction or break, (b) improper maintenance of any exercise equipment, premises or facilities, (c) negligent instruction or supervision, including personal training, (d) negligent hiring or retention of employees, and/or (e) slipping or tripping and falling while on any portion of a premises or while traveling to or from personal training, including injuries resulting from Coach/Personal Trainer’s or anyone else’s negligent inspection or maintenance of the facility or premises. INDEMNIFICATION: By execution of this agreement, you hereby agree to indemnify and hold harmless Coach/Personal Trainer from any loss, liability, damage, or cost Coach/Personal Trainer may incur due to the provision of personal training and wrestling by Coach/Personal Trainer to you. ACKNOWLEDGMENTS: You expressly agree that the foregoing release, waiver, assumption of risk and indemnity agreement is intended to be as broad and inclusive as permitted by the law in the State of Iowa and that if any portion thereof is held invalid, it is agreed that the balance shall, notwithstanding, continue in full legal force and effect. You acknowledge that Coach/Personal Trainer offers a service to his/her clients encompassing the entire recreational and/or fitness spectrum. Coach/Personal Trainer is not in the business of selling weightlifting equipment, exercise equipment, or other such products to the public, and the use of such items is incidental to the service provided by Coach/Personal Trainer. You acknowledge and agree that Coach/Personal Trainer does not place such items into the stream of commerce. This release is not intended as an attempted release of claims of gross negligence or intentional acts. You acknowledge that you have carefully read this waiver and release and fully understand that it is a release of liability, express assumption of risk and indemnity agreement. You are aware and agree that by executing this waiver and release, you are giving up your right to bring a legal action or assert a claim against Coach/Personal Trainer for Coach/Personal Trainer’s negligence, or for any defective product used while receiving personal training and/or coaching from Coach/Personal Trainer. You further agree that no oral representations, statements, or inducement apart from the foregoing written agreement have been made. Have you the Client and Client's Parent/Legal Guardian read and agree to these terms? Yes Cancellation/Rescheduling/Refund Policy * Please notify Coach Mason Miller at least 2 hours in advance of the scheduled in-person training meetings if needing to cancel. Coach Miller will attempt in good faith to reschedule the missed meeting within the week of the missed training session beginning Sunday and ending Saturday of the given week. Any unused sessions will not be refunded but may be rescheduled for up to 1 month after initial payment at the discretion of the Coach. All unused sessions expire 1 month after initial payment. Refunds requested in writing prior to the beginning of the Coaching Program will be given in full. The time of the in-person training meetings and/or location will be determined by Coach Miller, the client, and the client’s parent/legal guardian based on the seasonal training schedule and mutually agreed upon time. The Client will initiate all scheduling communications and call the Coach by telephone or communicate via email. Coach reserves the right to bill Client for a missed meeting. Have you the Client and Client's Parent/Legal Guardian read and agree to these terms? Yes Wrestling Technique/Skills Session Policies * Wrestling sessions will be conducted in 1-on-1 and/or Small Group (eight athletes or less of comparable weight) training to teach and implement a foundational technique system, teach drilling etiquette, and provide an environment where athletes can learn both offensive and defensive positions concurrently within a drill while still receiving individualized coaching attention. All sessions will be led by Coach Mason Miller. Have you the Client and Client's Parent/Legal Guardian read and understand these terms? Yes Social Media Policy * Coach Mason Miller may ask to take pictures and videos to be used on social media. If you, as the client or client’s parent/legal guardian, do not want you/your athlete to be displayed in these pictures or videos, please inform Coach Mason Miller either verbally or in writing expressing these concerns. Coach Mason Miller will allow pictures and videos to be recorded of practice/training sessions given the individuals in the media have provided consent. Do you the Client and Client's Parent/Legal Guardian give consent to be included in social media? Yes No Thank you!