Terms, Disclosures, Consent, Waiver

Consent Form – Client Request, Authorization, Expectation, Disclosure, and Disclaimer Form

I am voluntarily participating and requesting that Anna-Jane Macomber perform nutrition coaching, wellness/fitness mentoring and/or guidance for my general nutrition/wellness-related information which is not a substitute for my medical care. I understand that AJM attains a Holistic Nutritionist and Sports Nutritionist Certifications from a Credentialing Organization called The American Fitness Professionals & Associates. I understand AJ Macomber is not a Medical Doctor, Practitioner or a Licensed Registered Dietitian. I understand that AJM is not here for medical diagnostics, treatment procedures or medical nutrition therapy.

I understand while people generally experience greater health and wellness as a result of embracing a healthier attitude, lifestyle, and diet, these services do not promise or guarantee protection from past, present or future illnesses. I understand that changing my diet and lifestyle takes time and results do not generally occur quickly.

I understand that I should seek medical advice and be closely monitored by my physician or a licensed health care professional before starting or continuing any lifestyle changes such as but not limited to dietary changes, supplemental changes, or physical activity changes, especially if I may be pregnant, or have any pre-existing injuries or medical conditions.

I understand that I should read any information provided by the product manufacture and any product label or packaging prior to using any medication, nutritional, herbal, homeopathic, food/beverage or other products.

I understand that certain medications may have contraindications with introducing or continuing any supplemental or dietary changes, and that medications may need adjustments before and/or during my chosen lifestyle changes. I understand that adverse effects may lead to permanent damage or death if my medication(s) and/or healthcare needs are not properly monitored and amended with my physician.

I understand that I should not disregard or delay medical advice or treatment because of any wellness, fitness or nutrition-related information that has been shared with me. My decisions regarding my fitness, health and wellness are ultimately my own responsibility and the information provided should not to be taken as absolute.

I understand that nutritional or supplemental suggestions including information that may be provided directly or by linking to a third-party, or any affiliates are intended for my general nutrition-related information and education only and they will not be held accountable for the use or misuse of any suggestions therein.

I understand and agree that mentoring services may include but are not limited to understanding my health and nutrition status, as well as dietary, supplement, and exercise education. I understand that my sessions with AJ Macomber are confidential by nature and do not extend beyond our conversations, unless specifically permitted by me.

I understand that the mentoring and/or guidance views discussed with Anna-Jane Macomber are not necessarily aligned with any religion, ethnic group, club, organization, company, individual or any other professional business.I understand and agree to be contacted via email and/or phone messages/texts. For example, appointment confirmations, answers to questions that may include personal information, and any other pertinent info/health related information. I understand that email and phone correspondence may not be a secure route to protect my information and I do not hold Anna-Jane Macomber or World Gym accountable in the event of a security breach.

I understand that over time, currency and completeness of the information may change. I understand that this information is not intended and should not be construed as dispensing medical advice or claim to diagnose, treat, prevent, mitigate, prescribe, or cure any diseases, conditions, mental or physical, real or imaginary and that it is not a substitute for regular medical or psychological care. I understand that this interaction is not associated with any medical establishment and if I have an emergency of any kind to contact 911 or my local emergency service(s).

I agree to assume full responsibility for any risks, injuries or damage known or unknown which I might incur as a result of participating in these programs. Such injuries may include but are not limited to allergic reactions, feeling unwell, soreness, any other and/or including death.

Waiver

I, my heirs, successors or legal representatives forever release, voluntarily waive, discharge any claim, and covenant not to sue Anna-Jane Macomber including Iron Will Strength Studio LLC (aka Iron Legion Strength Co.), any owners, directors, managers, employees, instructors, officers, contractors, successors, building/landowners and assigns for any injury or damage that I may sustain physically, mentally, any such other, or death caused by their negligence (known or unknown) or other acts by participating in these programs. I agree to defend, protect and hold the harmless services rendered by Anna-Jane Macomber, Iron Will and their offices, affiliates or anything connected to their business from and against all claims, liabilities, damages, losses or expenses, including attorney fees and costs, arising out of or in any way connected with my access to or use of their services in any form forever.

I have read all the above and fully understand its contents. I voluntarily agree to the terms and conditions stated above and within this document.

Financial Policy

I understand that I am responsible for payment of any services rendered to me and agree to pay Anna-Jane Macomber through Iron Will the total amount. I understand that 100% will be paid at the time of service. I understand Anna-Jane does not work with insurance companies and that I am responsible for handling any reimbursements I may have available to me.

Cancellations or Rescheduled Appointments (Missed Appointments) for One-On-One Coaching: I understand I must provide 24-hour notice to Anna-Jane to cancel or reschedule my appointments, by either email or phone. I understand that it is my responsibility to make a note on my personal calendar or other means notating my appointment date and time as I may not receive appointment reminders from Anna-Jane.

Website Terms/Privacy

Disclaimer

You understand that a coaching relationship is not psychological counseling or psychotherapy. The purpose to hire me, AJM, Holistic Nutrition Consultant, is for a coaching relationship and not for any other type of professional work. I will partner with the client with the understanding that the client is responsible for creating his or her own results. We will work collaboratively, and I will provide support to the client in identifying and achieving goals. I, AJM, am the sole proprietor of aj-macomber.com and I am not a medical doctor, Practitioner or a Licensed Registered Dietitian..

Recipients should seek medical advice and be closely monitored by their physician or a licensed health care professional before starting or continuing any lifestyle changes such as but not limited to, dietary changes, supplement changes, or physical activity changes, especially if you are pregnant or have any pre-existing injuries or medical conditions. You should read any information provided by the product manufacture and any product label or packaging prior to using any medication, nutritional, herbal, food, homeopathic or other products. Certain medications may have contraindications with introducing or continuing any supplemental or dietary changes, and that medications may need adjustments before and/or during your lifestyle changes. Adverse effects may lead to permanent damage or death if your medication(s) and/or healthcare needs are not properly monitored and amended between you and your physician. Do not disregard or delay medical advice or treatment because of any nutrition-related information that has been shared with you. Your decisions regarding your health and wellness are ultimately your own responsibility and the information provided is not to be taken as absolute nor is it a substitute for your medical care. Nutritional or supplemental suggestions including information that may be provided directly or by linking to a third-party, or any affiliates are intended for your general nutrition-related information and education only and will not be held accountable for the use or misuse of any suggestions described therein. Any mention of a specific brand name is not an endorsement of the product. Please note that, over time, currency and completeness of the information may change. These services or information provided do not promise or guarantee protection from past, present or future illnesses and it should not be construed as dispensing medical advice or claiming to diagnose, treat, prevent, mitigate, prescribe, or cure any diseases, conditions, mental or physical, real or imaginary and that it is not a substitute for regular medical or psychological care.

Privacy

The following explains my privacy policy and legal information about the use of this website: www.aj-macomber.com

I, AJ Macomber, respect the privacy of each individual who visits my website. All information included or provided by AJ Macomber, or by you as an individual visiting my site, will be used only in ways I’ve disclosed in the following disclaimer.

My Commitment to You

All of my website can be visited anonymously and you will not need to reveal any personal information about yourself just by visiting.

To protect your privacy, I have adopted the following principles:

I will never share, sell, or rent individual personal information to anyone without your prior permission or unless ordered to do so by a court of law.

I will only use the information in the context of your “One-on-One Coaching” consulting arrangement.

I will respect the Code of Ethics and keep all our sessions confidential.

However, by visiting my site and choosing to enter your personal information will be at your own risk.

Information Collected

I, AJM do not collect web analytics personally, however, the platform I use may use your information about your visit to my website using WordPress Analytics. They may use this information for statistical purposes to make sites more accessible to visitors but I am not aware that the information they collect is not provided to any other third party. The types of information that may be collected include:

The name of the domain from which you access the Internet.
The Internet address of the website used to gain access to our site.
The type of web browsing software and operating system you are using to view the site.
The date and time you accessed the site.
The pages you visit on the site.
The amount of time spent on the site.

There are various forms that are available to complete via my website for those interested in becoming a client. These forms ask for contact information (phone, address and email address). Detailed health information will be collected if I provide you with Personal Coaching sessions in person. Contact information from these forms is used to communicate with you and, at times, to provide you with information that you request. At no time will personal medical or health information be shared or made available to any person, company or other third-parties without your prior written permission.

Change in Terms of Privacy

I, AJM, reserve the right to alter my privacy policies. Any changes to the policy will be posted on this website.

Legal Use of This Website

You may access, download and print materials on this website for your personal use only. If you want to modify, distribute, publish, license, or post on another website, any information from my website you will need to obtain written consent from me, AJM, prior.

Permission to Copy and Distribute

Blog entries and videos will occasionally be posted on this website that is authored by various individuals. I, AJM, require that you adhere to the following if you choose to redistribute such information found on my website:

Blog entries, articles, recipes, etc. may be copied and redistributed provided the full document is used with no modifications, including author citations and copyright information. Your website or other publication must not contain any illegal, immoral, defamatory, derogatory, harassing, harmful, threatening, obscene, pornographic, racial or ethnic questionable material, or depict sexual situations.

Use of information cannot be used on a website or in a publication that contains any material that violates a patent, trademark, copyright, trade secret, confidential information, or other property rights of any third-party.

Third Party Websites, Content, Products and Services

I, AJM, may provide links to websites and access to content, products, and services from third parties.

I, AJM, am not responsible for the availability of, content and/or recommendations provided on third party websites. Please refer to the policies posted by their websites regarding privacy and other topics and policies before you use them.

I, AJM, am not responsible for third party content accessible through this site, including opinions, advice, statements, recommendations, and advertisements. You understand and agree that you bear all risks associated with the use of such content. If you choose to purchase any products or services from a third party, your relationship is directly with the third party.

You agree that I, AJM, am not responsible for: the quality of third-party or services, fulfilling any of the terms of your agreement with the seller, including delivery of products or services, and warranty obligations related to purchased products or services.

You agree that I, AJM, am not responsible for any loss or damage you may incur from dealing with a third party.

Limitations of Liability

I, AJM, shall not be liable for any damages suffered as a result of using, modifying, contributing, copying, distributing, or downloading materials from my website. You agree to hold me, AJM, harmless from, and you covenant not to sue me, AJM, for any claims based on using my website forever.

Indemnity

You agree to defend, indemnify and hold harmless AJM against any and all claims, liabilities, damages, losses or expenses, including reasonable attorneys’ fees and costs, arising out of or in any way connected with your access to or use of the website forever.

Applicable Laws

All matters relating to your access to, and use of, the website shall be governed by U.S. federal law or the laws of the State of Maine and New Hampshire. I, AJM, agree to submit to the jurisdiction of, and agree that venue is proper in, these courts in any such legal action or proceeding.