Adult Participant Form
This form is used to facilitate timely and appropriate medical response in case of an emergency. This form uses an SSL certified connection. It also is used to collect information pertaining your permissions and limitations regarding marketing, contact and release of liability. These forms are standard industry tools for experiential training vendors.
INTRODUCTION
You are about to participate in a low-impact, activity-based workshop or program. You may experience a variety of physical, mental and/or emotional challenges. For most of the time, you will be undertaking activity which is best described as moderate exertion, comparable to normal walking, raking leaves, paddling, light calisthenics, etc.
There may be situations during a program when you may experience vigorous exertion. This is comparable to slow jogging, tennis, swimming, shoveling snow, or climbing a ladder.
If these are activities in which you regularly engage without difficulty, you should be fit for participation. If any of these activities concern you or you have specific medical conditions, you should consult with a physician before participation. If you or your physician has any questions about these conditions or about the style of activities we will do during the program, contact Dan Ashe, lead trainer for Challenge Applications at (443)-262-2710 | danashe@challengeapplications.com
We recommend seeking a physician’s clearance if you have joint injuries or healing fracture(s), or if you have had recent surgery (within the last 12 months).
YOUR INFORMATION