Client testimonial authorization (rev 5 30 2013hn)

CLIENT TESTIMONIAL AUTHORIZATION FOR STEVEN WEISS What is a testimonial?

A testimonial is a way for you to share your experience and journey with others. They also helps to instill confidence in potential Clients who may be hesitant about the hiring a personal trainer.

I, _____________________________________, hereby grant exclusive permission to Steven Weiss & Anytime Fitness – Frederick, Maryland. to use the below testimonial on any form of media they use. This may include, but is not limited to, websites, social media sites, literature, presentations, fliers, brochures, lectures, etc.

I, _____________________________________, am allowing the use of my testimonial and/or photographs to be used publically.

Please tell us about your experience (please print or type - this is your testimonial): __________________________________________________________________________________________________________________ __________________________________________________________________________________________________________________ __________________________________________________________________________________________________________________ __________________________________________________________________________________________________________________ __________________________________________________________________________________________________________________ __________________________________________________________________________________________________________________ __________________________________________________________________________________________________________________ __________________________________________________________________________________________________________________ __________________________________________________________________________________________________________________ __________________________________________________________________________________________________________________ __________________________________________________________________________________________________________________ __________________________________________________________________________________________________________________ __________________________________________________________________________________________________________________

Anytime Fitness | Client Testimonial (rev. 5-30-2013)

I participated in: □ Individual Training with Steven Weiss □ NXS Metabolic Resistance Training with Steven Weiss I started my training, _____________________ and completed ______________ sessions.

I allow my initials, or first name to be used with my testimonial. (if YES, circle one) INITIALS ONLY FIRST NAME ONLY

YES

NO

Would you recommend friends and family to our trainers/ facility?

YES

NO

Can we use an excerpt of your testimonial? (what you really said, not paraphrased)

YES

NO

Are you including photograph(s)? (ex. before and after photos or just a current picture if yourself) PLEASE DO NOT INCLUDE OTHERS IN YOUR PHOTOGRAPH(S).

YES

NO

I, _____________________________________, understand that I have the right, at any time, to withdraw my testimonial and/or photographs by contacting Steven Weiss on 301-693-1229. Please allow 1 week for such testimonials, photographs, etc. to be removed from media.

Please bring/mail completed authorization to, we will ask that you email photos if you want them included: 6077 Spring Ridge Pkwy ATTN: Steven Weiss Frederick, MD 21701 You may also email to: Steven@nxsfitness.com Client Name:_____________________________________________________________________ (Client name, please print clearly)

Date: ___________

Client Signature: ________________________________________________________________ (Signature of Client)

Thank you for your participation and willingness to encourage other members to make the healthy lifestyle changes you have committed to. I greatly appreciate your time and wanting to share your experiences and journey with others!

Steven Weiss  Anytime Fitness | Client Testimonial (rev. 5-30-2013)