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Day One Sports Performance
Day One Sports, LLC. Performance 2017 Program Waiver and Release of Liability: This Document affects your legal rights. Read it carefully.
My Participation in the Day One Performance, LLC Summer 2017 is voluntary. I agree and acknowledge that this athletic programs requires physical exertion and mental limits to be pushed. The risks include, but are not limited to, those caused by weight room equipment, facilities, temperature, condition of athletes, equipment, actions of other people including, but not limited to, other participants, other facility users, and coaches/interns of Day One Sports Performance, LLC. These risks are not only inherent to athletes, but also present for coaches/interns of Day One Sport Performance, LLC. Understanding this, I am aware that participating in this program involves potential body risk of bodily injury or personal property damage including, but not limited to, accidents, illnesses, injuries to, or death to me, or any other participants. I further understand that part of the risk involved in undertaking any program of this nature is relative to my own current state of fitness or heart and to my own awareness, care and skill in the manner in which I conduct myself while I am participating in the program.
Required
Release, Hold Harmless, and Convenant Not to Use:
I agree to release, hold harmless, and covenant not to sue Day One Sports Performance, LLC. I understand this release, hold harmless, and covenant to to sue is limited to claims for ordinary negligence and in no way shall be construed to release claims for conduct that constitutes greater than ordinary negligence, conduct that constitutes reckless or grossly negligent conduct, or willful, wanton, or intentional acts.
I further acknowledge that the terms of this release will serve as a release and assumption of risk applicable and binding on my heirs, executors, administrators, coaches, and others.
I hereby consent to receive Medical treatment, which may be deemed advisable in the event of injury, accident and/or illness during the event.
I understand that at this program I may be photographed or videoed. I agree to allow my photo, video, or film likeness to be used for advertising purposes by Day One Sports Performance, LLC.
I understand that signing this agreement affects my legal rights and results in my giving up or wavering certain legal rights and I accept this and sign this agreement of my own free will. My signature and Legal Guardian's signature (minors) if necessary indicates that I have read this entire document, understand it complete, acknowledge that it cannot be modified or changed in any way by oral representations and agree to be bound by its terms. This agreement shall be binding on behalf of my heirs, assigns, personal representative, legal guardian (minors), estate and myself.
I hereby certify by my signature (minors: guardian signature too) on this document that I have read this document; and, I, understand its content to the entire purpose.
Athlete Printed Name & Legal Guardian Printed Name & Date:
Your answer
PAR-Q
Questionnaire for people aged 10 to 69
Has your doctor ever said you have a heart condition and should only do physical activity recommended by a doctor?
Do you feel pain in your chest when you do physical activity?
In the past month, have you had chest pain when you were not doing physical activity?
Do you lose your balance because of dizziness or do you ever lose consciousness?
Do you have a bone or joint problem that could be made worse by physical activity?
Is your doctor currently prescribing drugs for blood pressure or a heart condition?
Do you know any reason why you should not do physical activity?
If you have answered YES to one or more of these questions:
Talk with your doctor BEFORE you become more physically active or BEFORE you participate in Day One Sports Performance LLC strength and conditioning program. Tell your doctor about the PAR-Q and which questions you answered YES to. With any questions you answered YES to we advise you seek medical advice before beginning this Summer Strength and Conditioning program.
I have read, understood, and completed this questionnaire. Any questions I had were answered to my full satisfaction. I agree to waive medical clearance from a physician although I have been advised it may be needed. Athlete Printed Name & Guardian Printed Name & Date:
Your answer
Name:
Your answer
Email:
Your answer
Cell Phone:
Your answer
Grade in School:
Your answer
Primary Sport:
Your answer
Group Time Slot:
Your answer
Other Sports:
Your answer
Any Current Injuries, previous injuries, injury concerns, or Surgery History:
Your answer
How recent was the recent surgery or major injury?
Your answer
Expectations for what you want to achieve this summer with Day One:
Your answer
Any Concerns you may have for the summer with Day One Sports Performance?
Your answer
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