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Cleveland Area Rucking Crew Waiver

Health Assessment Waiver

INFORMED CONSENT/ASSUMPTION OF RISK

I agree to participate in one or more physical fitness event(s) sponsored by Cleveland Area Rucking Crew, which may include, but not necessarily be limited to, ruck training, and/or training of any kind by any affiliate, subsidiary or partnership of Cleveland Area Rucking Crew and/or Bryan Singelyn (hereinafter collectively referred to as Cleveland Area Rucking Crew or CARC). Cleveland Area Rucking Crew made me fully aware that the events which Cleveland Area Rucking Crew offers and in which I desire to participate are of a nature and kind that are extremely strenuous and can/may push me to the limits of my physical abilities. I the undersigned recognize and understand that the events are not without varying degrees of risk which may include, but are not limited to the following: Injury to the musculoskeletal and/or cardio respiratory systems which can result in serious injury or death due to negligence on the part of myself, my training partner, or other people around me, injury or death due to improper use or failure of equipment, or injury or death due to a medical condition, whether known or unknown by me. I am aware that any of these above mentioned risks may result in serious injury or death to myself and or my partner(s).

Date: March 29, 2024

I willingly assume full responsibility for any and all risks that I am exposing myself to as a result of my participation in Cleveland Area Rucking Crew events and accept full responsibility for any injury or death that may result from participation in any activity, event, or physical fitness training. I hereby certify that I know of no medical problems that would increase my risk of illness and injury as a result of participation in an event or physical fitness training designed by Cleveland Area Rucking Crew. Cleveland Area Rucking Crew informed me that there exists the possibility of adverse physical changes during a rucking event and/or physical fitness training, and I fully understand the same. Cleveland Area Rucking Crew informed me that these changes could include abnormal blood pressure, fainting, rhabdomyolysis, disorder of heart rhythm, stroke, and in very rare instances, heart attack or even death, and I fully understand the same. With my full understanding of the above information, I agree to assume any and all risk associated with my participation in Cleveland Area Rucking Crew events and/or physical fitness training sessions.

Date: March 29, 2024

RELEASE

In full consideration of the above mentioned risks and hazards and in full consideration of the fact that I am willingly and voluntarily participating in the activities made available by Cleveland Area Rucking Crew, and with my full understanding of all of the above, I hereby waive, release, remise and discharge Cleveland Area Rucking Crew and its agents, officers, principals, and employees and volunteers, of any and all liability, claims, demands, actions or rights of action, or damages of any kind related to, arising from, or in any way connected with, my participation in Cleveland Area Rucking Crew events and/or physical fitness training, including those allegedly attributed to the negligent acts or omissions of the above mentioned parties.

This agreement shall be binding upon me, my successors, representatives, heirs, executors, assigns, or transferees. If any portion of this agreement is held invalid, I agree that the remainder of the agreement shall remain in full legal force and effect.

If I am signing on behalf of a minor child, I also give full permission for any person connected with Cleveland Area Rucking Crew to administer first aid deemed necessary, and in case of serious illness or injury, I give permission to call for medical and or surgical care for the child and to transport the child to a medical facility deemed necessary for the wellbeing of the child.

Date: March 29, 2024

INDEMNIFICATION

I recognize that there is risk involved in the types of activities offered by Cleveland Area Rucking Crew. Therefore I accept financial responsibility for any injury that I or the participant may cause either to him/herself or to any other participant due to his/her negligence. Should the above mentioned parties, or anyone acting on their behalf, be required to incur attorney’s fees and cost to enforce this agreement, I agree to reimburse them for such fees and costs. I further agree to indemnify and hold harmless Cleveland Area Rucking Crew, their principals, agents, employees, and volunteers from liability for injury or death of any person(s) and damage to property that may result from my negligent or intentional act or omission while participating in actives offered by Cleveland Area Rucking Crew.

Date: March 29, 2024

HEAVY DROP TRAINING (HDT) DISCLAIMER

Heavy Drop Training, also known as HDT, is a product of Cleveland Area Rucking Crew LLC. The following content or the content contained herein, which includes but is not limited to Heavy Drop Training workouts, Heavy Drop Training private workout videos (via YouTube), or the Heavy Drop Training workout template/structure as outlined at www.heavydroptraining.com (the aforementioned being considered INFORMATION INTENDED TO THE PURCHASER ONLY), shall be used exclusively by paid or gifted members of the program for their personal, individual and non-commercial use and shall not be reproduced, distributed, disseminated or shared with a third party, including employers of paid or gifted members, corporations, partnerships, non-profits, etc. without the written consent or authorization of Bryan Singelyn and/or Cleveland Area Rucking Crew LLC.

Date: March 29, 2024

HEAVY DROP TRAINING (HDT) NON-DISCLOSURE

INFORMATION INTENDED FOR THE PURCHASER ONLY (PURCHASED OR GIFTED)

  • All written and oral information and materials disclosed or provided by Cleveland Area Rucking Crew LLC (and the Heavy Drop Training Program) to the purchaser (signee) under this agreement constitute 'Information Intended for the Purchaser Only' (also known as Confidential Information throughout this agreement) regardless of whether such information was provided before or after the date of this agreement or how it was provided to the purchaser (signee).
  • ‘Information intended to the purchaser only’ means all data and information relating to the transaction and Cleveland Area Rucking Crew LLC, including but not limited to, the following:
    • ‘Intellectual Property’ which includes information relating to Cleveland Area Rucking Crew LLC’s proprietary rights prior to any public disclosure of such information, including but not limited to the nature of the proprietary rights, production data, technical and engineering data, technical concepts, test results, simulation results, the status and details of research and development of products and services, and information regarding acquiring, protecting, enforcing, and licensing proprietary rights (including patents, copyrights, and trade secrets);
    • ‘Marketing and Developing Information’ which includes marketing and development plans of Cleveland Area Rucking Crew LLC, price and cost data, price and fee amounts, pricing and billing policies, quoting procedures, marketing techniques, and methods of obtaining business, forecast, and forecast assumptions and volumes, and future plans and potential strategies of Cleveland Area Rucking Crew LLC which have been or being discussed;
    • ‘Product Information’ which includes all specifications for products of Cleveland Area Rucking Crew LLC as well as work product resulting from or related to work or projects of Cleveland Area Rucking Crew LLC, of any type or form in any stage of actual or anticipated research and development;
    • ‘Production Processes’ which includes processes used in the creation, production and manufacturing of the work product of Cleveland Area Rucking Crew LLC, including but not limited to, formulas, patterns, molds, models, methods, techniques, specifications, processes, procedures, equipment, devices, programs, and designs;
    • ‘Service Information’ which includes all sets of statements, instructions or programs of Cleveland Area Rucking Crew LLC, included but not limited to, plans, schedules, manpower, inspection, and training information;
    • ‘Proprietary Computer Code’ which includes all sets of statements, instructions or programs of Cleveland Area Rucking Crew LLC, whether in human readable or machine readable form, that are expressed, fixed, embodied or stored in any manner and that can be used directly or indirectly in a computer (‘Computer Programs’); any report format, design or drawing created or produced by such Computer Programs; and all documentation, design specifications and charts, and operating procedures which support the Computer Programs;
    • ‘Computer Technology’ which includes all scientific and technical information or material of Cleveland Area Rucking Crew LLC, pertaining to any machine, appliance or process, including but not limited to, specifications, proposals, models, designs, formulas, test results, and reports, analyses, simulation results, tables of operation conditions, materials, components, industrial skills, operating and testing procedures, shop practices, know-how and show-how; and
    • 'Information Intended for the Purchaser Only' will also include any information that has been disclosed by a third party to Cleveland Area Rucking Crew LLC and is protected by a non-disclosure agreement entered into between the third part and Cleveland Area Rucking Crew LLC.
  • 'Information intended to the purchaser only' will not include the following information:
    • Information that is now or subsequently becomes generally available to the public through no wrongful act of the purchaser (signee);
    • Information rightly in the possession of the purchaser (signee) prior to receiving the Information intended to the purchaser only from Cleveland Area Rucking Crew LLC;
    • Information that is independently created by the purchaser (signee) without direct or indirect use of the Information intended to the purchaser only; or
    • Information that the purchaser (signee) rightfully obtains from a third party who has the right to transfer or disclose it.

CONFIDENTIAL OBLIGATIONS

  • Except as otherwise provided in this agreement, the purchaser (signee) must keep the 'Information Intended for the Purchaser Only' confidential.
  • Except as otherwise provided in this agreement, the Information intended to the purchaser only will remain the exclusive property of Cleveland Area Rucking Crew LLC and will only be used by the purchaser (signee) for the permitted purpose. The purchaser (signee) will not use the 'Information Intended for the Purchaser Only' for any purpose that might be directly or indirectly detrimental to Cleveland Area Rucking Crew LLC or any associated affiliates or subsidiaries.
  • The obligations to ensure and protect the confidentiality of the 'Information Intended for the Purchaser Only' imposed on the purchaser in this agreement and any obligations to provide notice under this agreement will survive the expiration or termination, as the case may be, of this agreement and those obligations will last indefinitely.
  • The purchaser (signee) may disclose any of the 'Information Intended for the Purchaser Only':
    • to a third party where Cleveland Area Rucking Crew LLC has consented in writing to such disclosure; and
    • to the extent required by law or by the request or requirement of any judicial, legislative, administrative or other governmental body.
  • The purchaser (signee) agrees to retain all 'Information Intended for the Purchaser Only' in their own personal possession and to store all Information intended to the purchaser only separate from other potentially public information. Further, the 'Information Intended for the Purchaser Only' may not be reproduced, transformed, or stored on a computer or device that is accessible to persons to whom disclosure may not be made, as set out in this agreement

NON-COMPETITION

  • The agreement to partake on any training program, including but not limited to Heavy Drop Training and alike, is not satisfactorily completed by both Cleveland Area Rucking Crew LLC and the purchaser (signee), then:
    • Other then with the express written consent of Cleveland Area Rucking Crew LLC, which consent may not be unreasonably withheld, the purchaser (signee), from the date of the signing of this agreement until 5 years there after, will not directly or indirectly be involved with a business which is in direct competition with the business lines of Cleveland Area Rucking Crew LLC that are subject to this agreement.
    • From the date of the signing of this agreement until 5 years there after, the purchaser (signee) will not divert or attempt to divert from Cleveland Area Rucking Crew LLC any business Cleveland Area Rucking Crew LLC had enjoyed, solicited, or attempted to solicit, from its customers, at the time the parties entered into this agreement.

OWNERSHIP AND TITLE

  • Nothing contained in this agreement will grant to or create in the purchaser (signee), either expressly or impliedly, any right, title, interest or license in or to the intellectual property of Cleveland Area Rucking Crew LLC

REMEDIES

  • The purchaser (signee) agrees and acknowledges that the 'Information Intended for the Purchaser Only' is of a proprietary and confidential nature and that any failure to maintain the confidentiality of the 'Information Intended to the Purchaser Only' in breach of this agreement cannot be reasonably or adequately compensated for in money damages and would cause irreparable injury to Cleveland Area Rucking Crew LLC. Accordingly, the purchaser (signee) agrees that Cleveland Area Rucking Crew LLC is entitled to, in addition to all other rights and remedies available to it at law or in equity, an injunction restraining the purchaser (signee) and any agents of the purchaser (signee), from directly or indirectly committing or engaging in any act restricted by this agreement in relation to the 'Information Intended to the Purchaser Only'.

RETURN OF CONFIDENTIAL INFORMATION

  • The purchaser (signee) will keep tract of all 'Information Intended to the Purchaser Only' provided to them and the location of such information. Cleveland Area Rucking Crew LLC may at anytime request the return of all 'Information Intended to the Purchaser Only' from the purchaser (signee). Upon the rest of Cleveland Area Rucking Crew LLC, or in the event that the purchaser (signee) ceases to require use of the 'Information Intended to the Purchaser Only', or upon the expiration or termination of this agreement, the purchaser (signee) will:
    • return all 'Information Intended to the Purchaser Only' to Cleveland Area Rucking Crew LLC and will not retain nay copies of this information;
    • destroy or have destroyed all memoranda, notes, reports and other works based on or derived from the purchaser’s (signee) review of the  'Information Intended to the Purchaser Only' and
    • provide a certificate to Cleveland Area Rucking Crew LLC that such materials have been destroyed or returned, as the case may be.

NOTICES

  • In the event that the purchaser (signee) is reqired in a civil, criminal, or regulatory proceeding to disclose any part of the  'Information Intended to the Purchaser Only', the purchaser (signee) will give to Cleveland Area Rucking Crew LLC prompt written notice of such request so Cleveland Area Rucking Crew LLC may seek an appropriate remedy or alternatively to waive the purchaser’s (signee) compliance with the provisions of this agreement in regards to the request.
  • If the purchaser (signee) loses or fails to maintain the confidentiality of any of the  'Information Intended to the Purchaser Only' in breach of this agreement, the purchaser (signee) will immediately notify Cleveland Area Rucking Crew LLC and take all reasonable steps necessary to retrieve the lost or improperly disclosed Confidential Information.
  • Any notices or delivery required in this agreement will be deemed completed when hand-delivered, delivered by agent, or seven (7) days after being placed in the post, postage prepaid, to the parties at all addresses contained in this agreement or as the parties may later designate in writing.
  • The address for any notice to be delivered to any of the parties to this agreement are as follows:

Cleveland Area Rucking Crew LLC

8935 Darrow Rd.

PO Box 234

Twinsburg, Ohio 44087

REPRESENTATIONS

  • In providing the 'Information Intended to the Purchaser Only', Cleveland Area Rucking Crew LLC makes no representations, either expressly or impliedly as to its adequacy, sufficiency, completeness, correctness or its lack of defect of any kind, including any patent or trademark infringement that comes from the use of such information.

TERMINATION

  • Either party may terminate this agreement by providing written notice to the other party. Except as otherwise provided in this agreement, all rights and obligations under this agreement will be terminated at that time.

ASSIGNMENT

  • Except where a party has changed its corporate name or merged with another corporation, this agreement may not be assigned or otherwise transferred by either party in whole or part without the prior written consent of the other party to this agreement.

AMENDMENTS

  • This agreement may only be amended or modified by a written instrument executed by both Cleveland Area Rucking Crew LLC and the purchaser (signee).

GOVERNING LAW

  • This agreement will be construed in accordance with and governed by the laws of the State of Ohio.

GENERAL PROVISIONS

  • Time is of the essence in this agreement
  • This agreement may be executed in counterpart
  • Headings are inserted for the convenience of the parties only and are not to be considered when interpreting this agreement. Words in the singular mean and include the plural and vice versa. Words in the masculine mean and include the feminine and vice versa.
  • The clauses, paragraphs, and subparagraphs contained in this agreement are intended to be read and construed independently of each other. If any part of this agreement is held to be invalid, this invalidity will not affect the operation of any other part of this agreement.
  • The purchaser (signee)is liable for all costs, expenses and expenditures including, and without limitation, the complete legal cost incurred by Cleveland Area Rucking Crew LLC in enforcing this agreement as a result of any default of this agreement by the purchaser (signee).
  • Cleveland Area Rucking Crew LLC and the purchaser (signee) acknowledge that this agreement is reasonable, valid, and enforceable. However, if a court of competent jurisdiction finds any of the provisions of this agreement to be too broad to be enforced, it is the intention of Cleveland Area Rucking Crew LLC and the purchaser (signee) that such provision be reduced in scope by the court only to the extent deemed necessary by that court to render the provision reasonable and enforceable, bearing in mind that it is the intention of the purchaser (signee) to give Cleveland Area Rucking Crew LLC the broadest possible protection to maintain the confidentiality of the  'Information Intended to the Purchaser Only'.
  • No failure or delay by Cleveland Area Rucking Crew LLC in exercising any power, right or privilege provided in this agreement will operate as a waiver, nor will any single or partial exercise of such rights, powers or privileges preclude any further exercise of them or the exercise of any other right, power or privilege provided in this agreement.
  • This agreement will inure to the benefit of and be binding upon the respective heirs, executors, administrators, successors, and assigns, as the case may be, of Cleveland Area Rucking Crew LLC and the purchaser (signee).
  • This agreement constitutes the entire agreement between the parties and there are no further items or provisions, either oral or otherwise.

Failure to follow the HDT Non-Disclosure can result in legal actions towards those that have violated this agreement, by signing this you are acknowledging your understanding of this agreement between you (the participant of Heavy Drop Training) and Cleveland Area Rucking Crew LLC.

Date: March 29, 2024

 

USE OF PICTURE(S)/FILM/LIKENESS

I agree to allow Cleveland Area Rucking Crew, its agents, officers, principals, employees and volunteers the picture(s), film and/or likeness of me for advertising purposes through photography and/or your own social media posts in regards to Cleveland Area Rucking Crew LLC and/or Heavy Drop Training events. In the event I choose not to allow the use of the same for said purpose, I agree that I must inform Cleveland Area Rucking Crew of this in writing. 

Date: March 29, 2024

I have fully read and fully understand the foregoing assumption of risk, and release of liability and I understand that by signing it obligates me to indemnify the parties named for any liability for injury or death of any person and damage to property caused by my negligent or intentional act or omission. I understand by signing this form I am waving valuable legal rights.

First Participant's Name

First Name*

Last Name*
First Participant's Date of Birth*
First Participant's Information

PARTICIPANTS HEALTH ASSESSMENT


Date of Last Full Physical: *
Do you work out at least 3 times a week:*
Are you currently taking medication:*

If yes, explain:
Do you have problems/injuries in any of the following areas including but not limited to your knees, lower back, neck, shoulder, or any other region?*

If yes, explain:
Has your doctor ever said that you have a heart condition and that you should only perform physical activity recommended by a doctor?*
No
Yes
Do you feel pain in your chest when you perform physical activity?*
No
Yes
In the past month, have you had chest pain when you are not performing any physical activity?*
No
Yes
Do you lose your balance because of dizziness or do you ever lose consciousness?*
No
Yes
Do you know of any other reason why you should not engage in physical activity?*
No
Yes

If you answered yes to one or more of the above questions, consult a physician before engaging in physical activity. Tell your physician which questions you answered "Yes" to. After medical evaluation, seek advice from your physician on what type of activity is suitable for your current condition. If you would like to explain your reasoning for choosing "Yes", do so within the text box.
First Participant's Signature*
Second Participant's Name

First Name*

Last Name*
Second Participant's Date of Birth*
Second Participant's Information

PARTICIPANTS HEALTH ASSESSMENT


Date of Last Full Physical: *
Do you work out at least 3 times a week:*
Are you currently taking medication:*

If yes, explain:
Do you have problems/injuries in any of the following areas including but not limited to your knees, lower back, neck, shoulder, or any other region?*

If yes, explain:
Has your doctor ever said that you have a heart condition and that you should only perform physical activity recommended by a doctor?*
No
Yes
Do you feel pain in your chest when you perform physical activity?*
No
Yes
In the past month, have you had chest pain when you are not performing any physical activity?*
No
Yes
Do you lose your balance because of dizziness or do you ever lose consciousness?*
No
Yes
Do you know of any other reason why you should not engage in physical activity?*
No
Yes

If you answered yes to one or more of the above questions, consult a physician before engaging in physical activity. Tell your physician which questions you answered "Yes" to. After medical evaluation, seek advice from your physician on what type of activity is suitable for your current condition. If you would like to explain your reasoning for choosing "Yes", do so within the text box.
Third Participant's Name

First Name*

Last Name*
Third Participant's Date of Birth*
Third Participant's Information

PARTICIPANTS HEALTH ASSESSMENT


Date of Last Full Physical: *
Do you work out at least 3 times a week:*
Are you currently taking medication:*

If yes, explain:
Do you have problems/injuries in any of the following areas including but not limited to your knees, lower back, neck, shoulder, or any other region?*

If yes, explain:
Has your doctor ever said that you have a heart condition and that you should only perform physical activity recommended by a doctor?*
No
Yes
Do you feel pain in your chest when you perform physical activity?*
No
Yes
In the past month, have you had chest pain when you are not performing any physical activity?*
No
Yes
Do you lose your balance because of dizziness or do you ever lose consciousness?*
No
Yes
Do you know of any other reason why you should not engage in physical activity?*
No
Yes

If you answered yes to one or more of the above questions, consult a physician before engaging in physical activity. Tell your physician which questions you answered "Yes" to. After medical evaluation, seek advice from your physician on what type of activity is suitable for your current condition. If you would like to explain your reasoning for choosing "Yes", do so within the text box.
Fourth Participant's Name

First Name*

Last Name*
Fourth Participant's Date of Birth*
Fourth Participant's Information

PARTICIPANTS HEALTH ASSESSMENT


Date of Last Full Physical: *
Do you work out at least 3 times a week:*
Are you currently taking medication:*

If yes, explain:
Do you have problems/injuries in any of the following areas including but not limited to your knees, lower back, neck, shoulder, or any other region?*

If yes, explain:
Has your doctor ever said that you have a heart condition and that you should only perform physical activity recommended by a doctor?*
No
Yes
Do you feel pain in your chest when you perform physical activity?*
No
Yes
In the past month, have you had chest pain when you are not performing any physical activity?*
No
Yes
Do you lose your balance because of dizziness or do you ever lose consciousness?*
No
Yes
Do you know of any other reason why you should not engage in physical activity?*
No
Yes

If you answered yes to one or more of the above questions, consult a physician before engaging in physical activity. Tell your physician which questions you answered "Yes" to. After medical evaluation, seek advice from your physician on what type of activity is suitable for your current condition. If you would like to explain your reasoning for choosing "Yes", do so within the text box.
Fifth Participant's Name

First Name*

Last Name*
Fifth Participant's Date of Birth*
Fifth Participant's Information

PARTICIPANTS HEALTH ASSESSMENT


Date of Last Full Physical: *
Do you work out at least 3 times a week:*
Are you currently taking medication:*

If yes, explain:
Do you have problems/injuries in any of the following areas including but not limited to your knees, lower back, neck, shoulder, or any other region?*

If yes, explain:
Has your doctor ever said that you have a heart condition and that you should only perform physical activity recommended by a doctor?*
No
Yes
Do you feel pain in your chest when you perform physical activity?*
No
Yes
In the past month, have you had chest pain when you are not performing any physical activity?*
No
Yes
Do you lose your balance because of dizziness or do you ever lose consciousness?*
No
Yes
Do you know of any other reason why you should not engage in physical activity?*
No
Yes

If you answered yes to one or more of the above questions, consult a physician before engaging in physical activity. Tell your physician which questions you answered "Yes" to. After medical evaluation, seek advice from your physician on what type of activity is suitable for your current condition. If you would like to explain your reasoning for choosing "Yes", do so within the text box.
Sixth Participant's Name

First Name*

Last Name*
Sixth Participant's Date of Birth*
Sixth Participant's Information

PARTICIPANTS HEALTH ASSESSMENT


Date of Last Full Physical: *
Do you work out at least 3 times a week:*
Are you currently taking medication:*

If yes, explain:
Do you have problems/injuries in any of the following areas including but not limited to your knees, lower back, neck, shoulder, or any other region?*

If yes, explain:
Has your doctor ever said that you have a heart condition and that you should only perform physical activity recommended by a doctor?*
No
Yes
Do you feel pain in your chest when you perform physical activity?*
No
Yes
In the past month, have you had chest pain when you are not performing any physical activity?*
No
Yes
Do you lose your balance because of dizziness or do you ever lose consciousness?*
No
Yes
Do you know of any other reason why you should not engage in physical activity?*
No
Yes

If you answered yes to one or more of the above questions, consult a physician before engaging in physical activity. Tell your physician which questions you answered "Yes" to. After medical evaluation, seek advice from your physician on what type of activity is suitable for your current condition. If you would like to explain your reasoning for choosing "Yes", do so within the text box.
Seventh Participant's Name

First Name*

Last Name*
Seventh Participant's Date of Birth*
Seventh Participant's Information

PARTICIPANTS HEALTH ASSESSMENT


Date of Last Full Physical: *
Do you work out at least 3 times a week:*
Are you currently taking medication:*

If yes, explain:
Do you have problems/injuries in any of the following areas including but not limited to your knees, lower back, neck, shoulder, or any other region?*

If yes, explain:
Has your doctor ever said that you have a heart condition and that you should only perform physical activity recommended by a doctor?*
No
Yes
Do you feel pain in your chest when you perform physical activity?*
No
Yes
In the past month, have you had chest pain when you are not performing any physical activity?*
No
Yes
Do you lose your balance because of dizziness or do you ever lose consciousness?*
No
Yes
Do you know of any other reason why you should not engage in physical activity?*
No
Yes

If you answered yes to one or more of the above questions, consult a physician before engaging in physical activity. Tell your physician which questions you answered "Yes" to. After medical evaluation, seek advice from your physician on what type of activity is suitable for your current condition. If you would like to explain your reasoning for choosing "Yes", do so within the text box.
Eighth Participant's Name

First Name*

Last Name*
Eighth Participant's Date of Birth*
Eighth Participant's Information

PARTICIPANTS HEALTH ASSESSMENT


Date of Last Full Physical: *
Do you work out at least 3 times a week:*
Are you currently taking medication:*

If yes, explain:
Do you have problems/injuries in any of the following areas including but not limited to your knees, lower back, neck, shoulder, or any other region?*

If yes, explain:
Has your doctor ever said that you have a heart condition and that you should only perform physical activity recommended by a doctor?*
No
Yes
Do you feel pain in your chest when you perform physical activity?*
No
Yes
In the past month, have you had chest pain when you are not performing any physical activity?*
No
Yes
Do you lose your balance because of dizziness or do you ever lose consciousness?*
No
Yes
Do you know of any other reason why you should not engage in physical activity?*
No
Yes

If you answered yes to one or more of the above questions, consult a physician before engaging in physical activity. Tell your physician which questions you answered "Yes" to. After medical evaluation, seek advice from your physician on what type of activity is suitable for your current condition. If you would like to explain your reasoning for choosing "Yes", do so within the text box.
Ninth Participant's Name

First Name*

Last Name*
Ninth Participant's Date of Birth*
Ninth Participant's Information

PARTICIPANTS HEALTH ASSESSMENT


Date of Last Full Physical: *
Do you work out at least 3 times a week:*
Are you currently taking medication:*

If yes, explain:
Do you have problems/injuries in any of the following areas including but not limited to your knees, lower back, neck, shoulder, or any other region?*

If yes, explain:
Has your doctor ever said that you have a heart condition and that you should only perform physical activity recommended by a doctor?*
No
Yes
Do you feel pain in your chest when you perform physical activity?*
No
Yes
In the past month, have you had chest pain when you are not performing any physical activity?*
No
Yes
Do you lose your balance because of dizziness or do you ever lose consciousness?*
No
Yes
Do you know of any other reason why you should not engage in physical activity?*
No
Yes

If you answered yes to one or more of the above questions, consult a physician before engaging in physical activity. Tell your physician which questions you answered "Yes" to. After medical evaluation, seek advice from your physician on what type of activity is suitable for your current condition. If you would like to explain your reasoning for choosing "Yes", do so within the text box.
Tenth Participant's Name

First Name*

Last Name*
Tenth Participant's Date of Birth*
Tenth Participant's Information

PARTICIPANTS HEALTH ASSESSMENT


Date of Last Full Physical: *
Do you work out at least 3 times a week:*
Are you currently taking medication:*

If yes, explain:
Do you have problems/injuries in any of the following areas including but not limited to your knees, lower back, neck, shoulder, or any other region?*

If yes, explain:
Has your doctor ever said that you have a heart condition and that you should only perform physical activity recommended by a doctor?*
No
Yes
Do you feel pain in your chest when you perform physical activity?*
No
Yes
In the past month, have you had chest pain when you are not performing any physical activity?*
No
Yes
Do you lose your balance because of dizziness or do you ever lose consciousness?*
No
Yes
Do you know of any other reason why you should not engage in physical activity?*
No
Yes

If you answered yes to one or more of the above questions, consult a physician before engaging in physical activity. Tell your physician which questions you answered "Yes" to. After medical evaluation, seek advice from your physician on what type of activity is suitable for your current condition. If you would like to explain your reasoning for choosing "Yes", do so within the text box.
Participant's Address
Address Line 1:*
Street address, P.O. box, company name, c/o
Address Line 2:
Apartment, suite, unit, building, floor, etc.
Country:*
City:*
State/Province:*
Zip/Postal:*
Parent or Guardian's Email Address

Email*

Confirm Email*
Emergency Contact

First Name*

Last Name*

Emergency Contact's Phone Number*
Parent(s) or court-appointed legal guardian(s) must sign for any participating minor (those under 18 years of age) and agree that they and the minor are subject to all the terms of this document, as set forth above.


By signing below the parent or court-appointed legal guardian agrees that they are also subject to all the terms of this document, as set forth above.
Parent or Guardian's Name

First Name*

Last Name*
Parent or Guardian's Date of Birth*
Parent or Guardian's Information

PARTICIPANTS HEALTH ASSESSMENT


Date of Last Full Physical: *
Do you work out at least 3 times a week:*
Are you currently taking medication:*

If yes, explain:
Do you have problems/injuries in any of the following areas including but not limited to your knees, lower back, neck, shoulder, or any other region?*

If yes, explain:
Has your doctor ever said that you have a heart condition and that you should only perform physical activity recommended by a doctor?*
No
Yes
Do you feel pain in your chest when you perform physical activity?*
No
Yes
In the past month, have you had chest pain when you are not performing any physical activity?*
No
Yes
Do you lose your balance because of dizziness or do you ever lose consciousness?*
No
Yes
Do you know of any other reason why you should not engage in physical activity?*
No
Yes

If you answered yes to one or more of the above questions, consult a physician before engaging in physical activity. Tell your physician which questions you answered "Yes" to. After medical evaluation, seek advice from your physician on what type of activity is suitable for your current condition. If you would like to explain your reasoning for choosing "Yes", do so within the text box.
Parent or Guardian's Signature*
Electronic Signature Consent*
By checking here, you are consenting to the use of your electronic signature in lieu of an original signature on paper. You have the right to request that you sign a paper copy instead. By checking here, you are waiving that right. After consent, you may, upon written request to us, obtain a paper copy of an electronic record. No fee will be charged for such copy and no special hardware or software is required to view it. Your agreement to use an electronic signature with us for any documents will continue until such time as you notify us in writing that you no longer wish to use an electronic signature. There is no penalty for withdrawing your consent. You should always make sure that we have a current email address in order to contact you regarding any changes, if necessary.


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