Prevention Werx
Performance Training
Waiver & Liability Form
I desire my child to engage voluntarily in an exercise program in order to attempt to improve their physical fitness. I understand that the activities are designed to place a gradually increasing workload on the musculoskeletal, metabolic, and/or cardiorespiratory system and thereby attempt to improve function. The reaction of the cardiorespiratory system to such activities cannot be predicted with complete accuracy. There is a risk of certain changes that might occur during or following the exercise. These changes might include, but not limited to, abnormalities of blood pressure or heart rate.
I understand that the purpose of the exercise program is to develop and maintain cardiorespiratory fitness, body composition, flexibility, muscular strength and endurance. A specific exercise plan will be given to me, based on my child's needs and interest. All exercise programs include warm-up, exercise, and cool down. The programs include, but are not limited to walking, jogging, aerobic exercise, and strength training. All programs are designed to place a gradually increasing workload on the body in order to improve overall fitness. The rate of progression is regulated by exercise target heart rate or perceived exertion of exercise.
I understand that I am responsible for maintaining a safe exercise environment virtually, in-person and in the gym. I will wear non-slip exercise footwear, pants that will not cause me to trip. It will be free of pets, rugs, and objects that I may trip over. I will place my exercise mat on a non-slip surface or will not step on my mat in an unsafe manner. If I am practicing my balance, I will stand near or counter or a wall to prevent falling.
I understand that I am responsible for monitoring my own child's condition throughout the exercise program and should any symptoms occur, If my child is participating in a live session, I will cease my participation and inform the instructor of the symptoms immediately. If needed, I will dial 911. If I am participating in a taped session, I would cease my participation and inform a family member of the symptoms immediately. If needed, I will dial 911. When in the gym the instructor may take lead to intervene with any emergency procedures within the scope of practice.
In the event that medical clearance must be obtained prior to my participation in the exercise program, I agree to consult my physician and obtain written permission from my physician prior to the commencement of any exercise program.
Also, in consideration for being allowed to participate in this exercise program, I agree to assume the risk of such exercise, and further agree to hold harmless Prevention Werx Performance, it’s employees and agents, from any and all claims, suits, losses or related causes of action for damages, including, but not limited to, such claims that may result in my injury or death, accidental or otherwise, during or arising in any way from the exercise program.
