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Participant Signature / ______
FitnessCenter Staff Signature
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Participant Name (Print) / ______
FitnessCenter Staff Name (Print)
Entering facility - Plaza members need to use the stairs to exit and the freight elevator to enter the building when wearing exercise clothes during normal business hours.
Computer log in - Sign in each time you use the FitnessCenter. Please use the fitness center during non-work hours only. (i.e., during lunch hour, before and after work).
Participant safety- Modifications of equipment for any exercise other than its intended use are prohibited (i.e. using to stretch muscles). Equipment can be dangerous if used improperly. For your safety, the FitnessCenter staff will supervise and monitor your exercise sessions and program on a scheduled rotation for all facilities. Monitoring may be in the form of heart rates (pulse), blood pressure readings, exercise recommendations, or any other necessary measure. Please adhere to suggestions made by the staff in regard to safety concerns.
Emergency procedures - In the event of an emergency evacuation, all members are required to exit the FitnessCenter as quickly as possible. In the event of a medical emergency, members are instructed to use the phone located in the FitnessCenter to dial 911.
Change in health status - It is your responsibility to inform the staff of any change in your health. Certain medical conditions require modifications to your exercise program for your continued safety. All health information is kept strictly confidential.
FitnessCenter etiquette/cleanliness Please help keep the facility neat and clean.Wipe down all equipment after usage and deposit all waste in trash receptacles. Be courteous. Allow others to work with you and please limit your cardio workouts to 30 minutes during
peak hours. To reduce noise pollution, please use your music device with headphones. Be aware of your surroundings and pay attention to what others are doing to avoid potential injuries.Bring a sweat towel to wipe off perspiration. Return dumbbells, plates, and bars to their proper place after use.
Exercise attire - A loose fitting T-shirt and exercise shorts or tights are recommended for exercise. Because this is a corporate facility, exercise attire should be appropriate for the work setting. A quality pair of exercise sneakers is highly recommended, and should suit the activity in which you are participating. Bare feet are not permitted outside the locker room and at no time will participants be permitted to exercise without proper footwear or proper attire. No work clothes or work shoes are allowed.
Appropriate changing area - Change clothes in restroom only. This includes partial dressing, i.e. taking off or putting on belts, unbuttoning pants, taking off or putting on shirts.
Member etiquette -The FitnessCenter is a comfortable environment for all employees. Members should be courteous and respectful of other members in the facility. Members must follow company guidelines and policies regarding employee behavioral standards. Be respectful of the facility and keep it clean. No gum or tobacco products allowed.No jewelry or belts on padded equipment. Inappropriate language and behavior is prohibited. Be aware of the appropriateness of what is being aired on the TV and/or radio when others are present.
Lockers - are for daily use only. Please remove items after use. The FitnessCenter is not responsible for items left/lost in the FitnessCenter or locker rooms.
Un-approved personal training-Under no circumstances is any member to train another member for compensation. For your safety, only individuals specifically approved and designated as personal trainers by MediFit may provide personal training services at the FitnessCenter.
Solicitation -Solicitation within the facility is strictly forbidden. This includes, for example, solicitation for profit, political purposes, or any other reason. This includes, but is not limited to, use of petitions, distributing or posting leaflets, notices, or advertising anywhere in the Fitness Center, or leaving multiple copies of leaflets or other papers in the facility.
Group exercise classes -These classes are open to all members. Most classes are included with your membership dues. Personal training classes may be subject to an additional fee, which will be noted on the group exercise calendar. All participants must sign in for class. Class space and equipment may be limited, so the sign in sheet will dictate the maximum number of participants. If different classes run back-to-back, participants must have signed in for both or run the risk of being asked to leave. If the same class runs back-to-back, priority goes to the newcomer. To ensure your spot in a group exercise class, you may sign up for a class five minutes prior to the start of that class.
Lost & found - Unidentified items will be placed in the lost and founddrawer located at the front desk. All other valuables will be kept in the staff office. Please see staff for assistance. Neither TECO Energy nor MediFit are responsible for lost or stolen items.
Photography/cell phone/recording - Cell phones are not to be used while exercising on equipment due to foreseeable injury. Cell phones with video/recording capabilities are not to be used in the FitnessCenter or locker rooms to protect the privacy of other members in the facility.
Membership termination - Members are responsible for completing a cancellation form and submitting it to the FitnessCenter staff. Verbal requests are not accepted, however, email requests are accepted provided a cancellation form has been completed. Refunds for membership dues will not be given under any circumstances other than a company payroll processing error. It is the member’s responsibility to confirm cancellation on his/her pay stub and contact FitnessCenter staff within 60 days if there is a discrepancy.
I do not want a personalized exercise program designed by a staff member. (SKIP BELOW) I would like to have a personalized exercise program designed by a staff member. (SEE BELOW)
Do you currently exercise most days of the week?
No, but I’d like to in the near future. (Contemplation) / Yes, I have been for less than 6 months. (Action)
Not consistently, but I intend to in the next 30 days. (Preparation) / Yes, I have been for more than 6 months.(Maintenance)
Do you perform any cardiovascular activity? Yes No
How often? / <1 time/month / 1-2 times/week / 3-5 times/week / 6-7 times/week
How long? / 10-20 minutes / 20-30 minutes / 30-45 minutes / 45-60 minutes
What intensity? / Low/Light / Moderate / High/Vigorous
Do you perform any strength training? Yes No
How often? / <1 time/month / 1-2 times/week / 3-5 times/week / 6-7 times/week
How many sets and repetitions do you typically do? / What muscles group do you typically train?
Abs Back Legs Arms Chest Shoulders
Do you perform any flexibility exercise? Yes No
Setting your S.M.A.R.T. Wellness goals.
Be very specific when setting goals. Your goals should have measurable values such as dates, times, pounds, inches, etc. Make them attainable and realistic. You can only achieve what is possible. Finally, establish a timeframe to reach goals.
S – Specific / Be specific when making goals. State exactly what you want.
M – Measurable / Your goals should include numbers—dates, times, pounds, inches.
A – Attainable / Your goal has to be attainable. You cannot achieve what is not possible.
R – Realistic / Make sure your goal is realistic. You don’t want to set yourself up for failure.
T – Time Specific / There should be a timeframe to achieve set goals.
List your goals, reasons why you want to accomplish them and barriers that may prohibit you from achieving them. / Target Date