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Client Liability Waiver

Contact & General Information

Physical Activity Readiness Questionnaire: PAR-Q

1. Has your doctor ever said that you have a heart condition and that you should only do physical activity reccomended by a doctor?
2. Do you feel pain in your chest when you do physical activity?
3. In the past month, have you had chest pain when you were not doing physical activity?
4. Do you lose your balance because of dizziness or do you ever lose conciousness?
5. Do you have a bone or joint problem that could be made worse by a change in your physical activity?
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 drugs for your blood pressure or heart condition?
7. Do you know of any other reason why you should not do physical activity?

Liability Release Form

Please read the information below carefully and sign and date at the bottom of this form. By signing below this Consent, you are agreeing to the stipulations and requirements of the Fitness Program. 

I understand that this Fitness Program is not a medically supervised program and that the Fitness Program is designed for healthy people with no medical conditions or risks, either physical or psychological. In addition to the terms above, I represent that I am in good physical condition and have no medical reason or impairment that might prevent me from participating in this Program. As such, I acknowledge that Training For A Higher Purpose, LLC, employees or affiliates did not give me medical advice before this program, and cannot give me medical advice after the Program, related to my physical condition and ability to participate. If I have any health concerns now, during, or after the Program, I will discuss them with my doctor. The information provided to me in any testing provided by Training For A Higher Purpose, LLC employees or affiliates is not intended to diagnose, treat, cure, prevent any disease and/or give medical advice of any kind.

Participating in Activities at or via the Company will also invariably place Releasee in close proximity with other individuals and in contact with surfaces or areas that may have been handled, touched, or come into contact with other individuals. Due to the nature of the Activities and Services, as well as the participation of other persons, the Company cannot guarantee that recommended social distancing will be followed at all times during the Activities and Services and cannot guarantee that surfaces and other areas or items the Releasee may come in contact with are free of viruses, bacteria, or other contaminants. Releasee acknowledges that cases of the novel coronavirus (“COVID-19”) have been confirmed throughout the United States, including, in Coon Rapids, MN. By volunteering to participate in the Activities and Services, Releasee appreciates, fully understands, and assumes the risk that Releasee may be exposed to and contract COVID-19 or any other communicable disease, including as a result of actions or inactions by the Company, by other activity participants, or by third parties. If Releasee is not aware of these risks which may come by participating in the Activities, Releasee should not participate until and unless Releasee has sought and received information from the Company which allows Releasee to have a fair and reasonable opportunity to know and understand said risks.

I understand that pictures or video may be taken during my involvement in this Fitness Program, which may be used for promotional purposes. I understand that I have no legal rights about how this promotional material is used and can not expect any type of royalty or payment for the use of this material. I understand that any before and after pictures will not be used, unless I give written consent. 

My participating in the Fitness Program naturally involves the risk of injury to me or my guest, whether I or someone else causes it. Specific risks vary from one activity to another, and the risks range from minor injuries to major injuries, such as catastrophic injuries, including death. As such, I understand and voluntarily accept this risk and agree that Training For A Higher Purpose, LLC and/or its employees and affiliates will not be liable for any injury, including without limitation, personal, bodily or mental injury, economic loss or any damage to me, my spouse, guests, unborn child, or relatives resulting from the negligence of Training for a Higher Purpose, LLC or anyone on Training For A Higher Purpose, LLC behalf whether related to exercise or not.

Thanks for submitting! Please continue through the booking process on the previous page.

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