Strong Bodies
Fall Class: Sept 14th - Nov 18th
Tuesdays & Thursdays @ 11:00 - 12:00pm
2021 Registration
Name (First and Last) *
Address *
Phone Number *
Email *
Gender (Demographics) *
Age (Demographics) *
Ethnicity (Demographics) *
Emergency Contact Name *
Emergency Contact Relationship *
Emergency Contact Phone Number *
Have you voluntarily enrolled in the Strong Bodies program? *
Required
Do you understand that there are risks to a program associated with exercise which may include muscle soreness, fainting, disorders of heart beat, abnormal blood pressure and in very rare instances heart attack? *
Required
Do you release everyone who has designed, promoted or conducted the Strong Bodies program from all claims or liabilities whatsoever resulting from your participation? *
Required
Do you assume all risks and responsibilities for any injury, damage, or any other adverse events that may result from your participation in this program? *
Required
Do you agree to be video recorded or photographed in class with the potential that your photo may be utilized in promotional materials? *
Required
Are you committed to competing the entire program by missing as few of the sessions as possible? *
Required
In-person participation will be very limited. If you decide to do the class in-person, you understand that a face masks will be required and worn properly over your nose & mouth throughout the full class per Strong Bodies regulations. *
Required
I would like to participate in the Strong Bodies Class (Choose one) *
I have voluntarily enrolled in a program of progressive exercise. The program is designed to place gradually increased workload on the heart, lungs, muscles and bones to help improve their function. I understand that participation in such a program may be associated with some risks. These risks may include but are limited to muscle soreness, fainting, disorders of the heartbeat, abnormal blood pressure, and in very rare instances heart attack. To the best of my knowledge I do not have any limiting physical conditions or disabilities that would preclude an exercise program. I release everyone who has designed, promoted or conducted the Strong Bodies program from all claims or liabilities whatsoever resulting from my participation in this program. I assume all risks and responsibilities for any injury, damage, or any other adverse event that may result from my participation in this program. Before I begin this program I understand that a pre-exercise assessment and physician screening consent form may be required. I understand that each person may react differently to these fitness activities and these reactions cannot be predicted with complete accuracy. I will inform the Program Leader and/or my health care provider if I experience any unusual symptoms. Signature by entering your name below and dating. *
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