Cor.Fit Participant Information Form
WAIVER AND RELEASE OF LIABILITY
Canadian Obstacle Race Fitness, Inc. (hereinafter called Cor.Fit) located at: 6481 30st SE Calgary, Alberta
*Express assumption of risk: I, the undersigned, am aware that there are significant risks involved in all aspects of physical training. These risks include, but are not limited to: falls which can result in serious injury or death, 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. I am aware that any of these above mentioned risks may result in serious injury or death to myself and or my partner(s). I assume full responsibility for the risks that I am exposing myself to and accept full responsibility for any injury or death that may result from participation in any activity or class while at Cor.Fit, Inc. or any other facility that Cor.Fit, Inc. holds classes or activities.
Please select Yes or No to the following questions (Parent/Guardian please complete on behalf of minor child:
*1. Has your doctor ever said that you have a heart condition and that you should only perform physical activity recommended by a doctor?
*2. Do you feel pain in your chest when you perform physical activity?
*3. In the past month, have you had chest pain when you were not performing any physical activity?
*4. Do you lose your balance because of dizziness or do you ever lose consciousness?
*5. Do you have a bone or joint problem that could be made worse by a change in your physical activity?
*6. Is your doctor currently prescribing any medication for your blood pressure or for a heart condition?
*7. Do you know of any other reason why you should not engage in physical activity?
If you have answered “Yes” to one or more of the above questions, consult your physician before engaging in physical activity. Tell your physician which questions you answered “Yes” to. After a medical evaluation, seek advice from your physician on what type of activity is suitable for your current condition.
I, acknowledge that I have no physical impairments or illnesses that will endanger myself or others.
*RELEASE: In consideration of the above mentioned risks and hazards and in consideration of the fact that I am, or minor is, willingly and voluntarily participating in the activities available at Cor.Fit, Inc., I, the undersigned hereby release Cor.Fit, Inc., their principals, agents, employees, and volunteers from any and all liability, claims, demands, actions or rights of action, which are related to, arise out of, or are in any way connected with my participation in this activity, 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 Cor.Fit, Inc. to administer first aid deemed necessary for myself and/or the child, and in case of serious illness or injury, I give permission to call for medial and or surgical care for myself and/or the child and to transport myself and/or the child to a medical facility deemed necessary for the well-being of myself or the child.
*I hereby give Cor.Fit, Inc., its assigns, licensees and legal representatives the irrevocable right to use my name or minors name/photograph/image/audio recording/video recording/ and likeness (“My Image”) in all forms and manner including but not limited to publication on Internet Web Sites, broadcasts and any other publications as released to or by Cor.Fit, Inc.. I understand that Cor.Fit, Inc. cannot control unauthorized use of My or minors Image by persons not associated with Cor.Fit, Inc. once My or minors Image has been published. I hereby forever waive any right to inspect or approve any publication of My or minors Image by Cor.Fit, Inc.. I also agree to receiveing email reminders, notifications, newsletters and other promotional information from Cor.Fit, Inc. and understand that I can opt out at any time in the future.
*I have carefully reviewed and understand the above provisions and agree to be bound by them. I voluntarily and irrevocably give my consent and agree to this Waiver & Release.
INDEMNIFICATION: The participant recognizes that there is risk involved in the types of activities offered by Cor.Fit, Inc.. Therefore the participant accepts financial responsibility for any injury that the participant may cause either to him/herself or to any other participant and or minor due to his/her negligence. Should the above mentioned parties, or anyone acting on their behalf, be required to incur attorney’s fees and costs to enforce this agreement, I agree to reimburse them for such fees and costs. I further agree to indemnify and hold harmless Cor.Fit, Inc., their principals, 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 acts or omission while participating in activities offered by Cor.Fit, Inc..
I have read and understand the foregoing assumption of risk, and release of liability and I understand that by signing this form I am waiving valuable legal rights.
Signature of Participant or Parent/Guardian if participant is under the age of 18: