Physical Activity Readiness Questionnaire/Waiver

Physical activity should not be hazardous for most people. The PAR-Q has been designed to identify those individuals who should seek medical attentions prior to beginning a physical fitness program. Please answer all questions accurately and honestly to allow us to fully determine your individual needs.

Name *
Name
Address *
Address
Phone *
Phone
Do you have any past injuries? Or have injuries now? *
Have you ever played any type of sports before? If yes, please list what they were and how long ago. *
Informed consent/Assumption of Risk:
Buyer acknowledgment and assumption of risk and full release from liability of Steel Fox CrossFit & Steel-Fit buyer acknowledges these physical activities involves the inherent risk of physical injuries or other damages, including, but not limited to, heart attacks, muscle strains, pulls or tears, broken bones, shin splints, heart prostration, knee/lower back/foot injuries and any other illness, soreness, or injury however caused, occurring during or after buyer's participation in the physical activities. Buyer further acknowledges that such risks include, but are not limited to, injuries caused by the negligence of an instructor or other person, defective or improperly used equipment, over-exertion of a buyer, slip and fall by buyer, or an unknown health problem of buyer. Buyer agrees to assume all risk and responsibility involved with participation in the physical activities, buyer affirms that buyer is in good physical condition and does not suffer from any disability that would prevent or limit participation in the physical activities. Buyer acknowledges participation will be physically and mentally challenging, and buyer agrees that it is the responsibility of buyer to seek competent medical or other professional advice, regarding any concerns or questions involved with the ability of buyer to take part in Steel Fox CrossFit & Steel-Fit physical activities. By signing this agreement, buyer asserts that he or she is capable of participating in the physical activities. Buyer agrees to assume all risk and responsibility for not exceeding his or her physical limits.
INFORMED CONSENT/PHOTO & VIDEO RELEASE:
Buyer acknowledgment granting permission to Steel Fox CrossFit & Steel-Fit to use my photography/video image in any and all publications related to the use of fitness, including websites, social media, publications, without payment or any other consideration in perpetuity. I hereby authorize Steel Fox CrossFit & Steel-Fit to edit, alter, copy, exhibit, publish or distribute all photos and images. I waive any right to royalties or other compensation arising or related to the use of the photography or video images. I hereby hold harmless and release and forever discharge Steel Fox CrossFit & Steel-Fit from all claims, demands, and causes of action which I, my heirs, representatives, executors, administrators, or any other persons acting on my behalf of on behalf of my estate which may have or may have by reason of this authorization.
INFORMED CONSENT/INDEMNIFICATION
Buyer acknowledgment that there is a risk with any fitness program including the programs at Steel Fox CrossFit & Steel-Fit. Therefore, I accept financial responsibility for any injury that may cause either to myself 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 Steel Fox CrossFit & Steel-Fit, their principles, agents, employees, and volunteers from liability for the injury or death of any person(s) and damage to property that may result from my negligent or intentional act of omission while participating in activities offered by Steel Fox CrossFit & Steel-Fit.
I HAVE FULLY READ AND FULLY UNDERSTAND THE FOREGOING ASSUMPTION OF RISK, AND RELEASE OF THE LIABILITY AND I I UNDERSTAND THAT BY SIGNING THIS FORM I AM WAIVING LEGAL RIGHTS. I AM AWARE THAT THIS IS A RELEASE AND WAIVER OF LIABILITY AND SIGN IT KNOWINGLY, VOLUNTARILY, AND OF MY OWN FREE WILL.
Date *
Date
If the participant is under the age of 18:
Date
Date