INFORMED CONSENT AGREEMENT

And

LIABILITY WAIVER

 

Informed Consent Agreement

Program Objectives

I understand that I will be completing these workout programs unsupervised and that I accept all risk involved.  I also acknowledge that I am in good health and able to lift weights and other objects prescribed in the programs I select.  I understand that my results will be dependent solely by the effort I put forth. 

Description of the Exercise Program

I understand that my unsupervised exercise program will involve participation in a number of fitness activities.

These activities will vary depending upon my established objectives, but will probably include:

1) aerobic activities including, but not limited to, the use of TRX suspension, treadmills, stationary bicycles, rowing machines, and running track;

2) muscular endurance and strength building exercises including, but not limited to, the use of free weights, kettlebells, sandbags, weight machines, barbells, TRX suspension, calisthenics, and other exercise apparatus;

Description of Potential Risks

I am aware that no exercise program is without inherent risks.  For example, when one induces cardiovascular stress through activity, injuries can range from occasional minor injury (e.g., pulled muscles, muscle soreness) to infrequent serious injury (e.g., heart attack, stroke, or other cardiovascular accidents) to the very rare catastrophic incident (e.g., death, paralysis). Likewise, I know that engaging in muscular endurance, strength building, and other fitness activities occasionally results in minor injuries (e.g., bruises, musculo-skeletal strains, and sprains), infrequently, more serious injuries (e.g., muscle tears, herniated disks, torn rotator cuffs), and very rarely, catastrophic injury (e.g., death, paralysis).  I realize that when participating in any exercises or conditioning activity, there is always a possibility that minor injuries, major injuries, or catastrophic injury/death may occur.

Description of Potential Benefits

I understand that a regular exercise program has been shown to have definite benefits to general health and well-being. I know that some of the physiological benefits of a regular exercise program can include loss of weight, reduction of body fat, improvement of blood lipids, lowering of blood pressure, improvement in cardiovascular function, reduction in risk of heart disease, improved strength and muscular endurance, improved posture, and improved flexibility. I further understand that regular exercise can have psychological benefits, often improving one’s outlook and feeling of well-being, as well as relieving tension and stress.

Athlete Responsibilities

I understand if I select the Athlete-Custom program that it is my responsibility to:

1) fully disclose any health issues (including diabetes, heart problems, seizures, and asthma) or medications that are relevant to participation in a strenuous exercise program;

2) inform Rugged Athlete if there are activities with which I do not feel comfortable;

3) cease exercise and report promptly any unusual feelings (e.g., chest discomfort, nausea, difficulty breathing, apparent injury) during the exercise program; and

4) clear my participation with my physician.

Athlete Acknowledgements

In agreeing to this exercise program, I, the athlete:

• acknowledge that my participation is completely voluntary.

• understand the potential physical risks involved in the exercise program/Bootcamp and believe that the potential benefits outweigh those risks.

• give consent to certain physical touching that may be necessary to ensure proper technique and body alignment.

• understand that the achievement of health or fitness goals cannot be guaranteed.

• have had a voice in planning and approving the activities selected for my exercise program.

• have been able to ask questions regarding any concerns I might have, and have had those questions answered to my satisfaction.

am in good physical condition, have no impairment which might prevent my participation in such activities, and have been advised to consult a physician prior to beginning this program

• have been advised to cease exercise immediately if I experience unusual discomfort and feel the need to stop.

I have read and understand the above agreement.   I have been made fully aware of and understand the potential risks involved in this unsupervised physical fitness program.   I hereby consent to those risks and am freely and voluntarily participating in this program. Finally, I am freely signing this agreement and am aware that there is a NO REFUND policy.

____________________________________________________         

Signature of Athlete                                                            Date                   

____________________________________________________

Signature of Rugged Athlete                                              Date

 

 

Liability Waiver Form

I, __________________________________________, certify and acknowledge:

That I, ________________________________, freely and knowingly assume the risk in such programs, and I hereby waive any right, claim, or cause of action against Rugged Athlete, and release  from any liability for any injury, cost, damage expense or claim, which I or anyone on my behalf might incur as a direct or indirect result of my participation in this cardiovascular and resistance-training program.

That I, ______________________________________, have read this Liability Waiver form, understand, and agree with each of the foregoing points, and have received a copy of this release form on this date.

 

Athlete Name: ______________________________________________________

 

Signature:

______________________________________________________

 

Date: ______________________________________________________