Liability Release
This release is entered into between the undersigned and Columbia Fitness Boot Camp, boot camp instructors, affiliates, contractors, executors in addition to the City of Columbia , Lexington and Richland Counties . The purpose of the Columbia Boot camp is to provide fitness instruction and coaching for various levels of athletes/individuals.
The undersigned hereby acknowledge that the following was explained to me and/or agree to the following:
- Acknowledges that Columbia Fitness Boot Camp Instructors are not physicians and is not trained in any way to provide medical diagnosis, medical treatment, or any other type of medical advice.
- Acknowledges that coaching/training is another tool for teaching athletes/individuals about themselves, but that Boot Camp Instructors does not guarantee neither good nor bad will occur nor guarantees the training advice given by Columbia Fitness Boot Camp Instructors will produce good nor bad results.
- Acknowledges that the undersigned has been told if they feel tired, feel pain or feel out of the ordinary in any way either related to your training, or otherwise, that the undersigned should contact a physician at once.
- Acknowledges that boot camps, aerobic classes, martial arts, kick boxing, running, kung-fu, weight training, obstacle courses, and any other related sports are an extreme test of one's mental and physical limits and carry with it potential for damage or loss of property, serious injury and death. That the undersigned assumes the risks of participating in these types of events/activities including the inherent dangers of the natural elements, that they are fit, and they have a regular medical physician they can contact regarding any medical problems that they might develop. The undersigned expressly waive, release, discharge and agree not to sue from any liability of death, disability, personal injury, or action of any kind and Columbia Fitness Boot Camp Owners, boot camp instructors, affiliates, contractors, employees and Irmo Chapin Recreation commission for the undersigned participating in said sporting events and/or training for said sporting events.
The Undersigned agrees that this is the full agreement between the parties, that Columbia Fitness Boot Camp Owners, Affiliates, Contractors, Employees, nor anyone else has not verbally contradicted any of the terms of this release and that the undersigned has entered into this agreement freely and voluntarily without force or coercion.
- Columbia Boot Camp reserves the right to cancel camp for instructor illness, or family emergency, inclement weather, and other unforeseen events. All efforts will be made to find a qualified substitute in the event of instructor illness or family emergency
Initial the following:
I agree to show up for Boot Camp every day unless it is an excused absence from my doctor or pre-approved with Boot Camp directors. Any violation will result in twenty push-ups per occurrence.
I understand that photos or video may be taken during the course of my involvement in Boot Camp, which may be used for promotional purposes. I understand that my "before & after" photos will not be used for any promotional purposes unless I give written authorization.
I understand there is no refund policy, but I can receive a credit (for unused portion of camp) towards a future camp if I'm not able to complete the one I originally joined. Camp fees can not be used towards any other products or services provided by Columbia fitness Boot Camp.
I will remember to set my alarm and be at camp on time.
I understand that diet and nutrition will affect my fitness goals and performance during boot camp.
Your signature will be required at the time of your evaluation and you agree to the terms now!
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Please check which camp you are registering for: |
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| Please select your location: |
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| Please select your time: |
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| Health Questionnaire |
1. Has a doctor diagnosed you with any heart conditions?
Examples include: mitral valve prolapse, myocardial infarction, angina, dysrhythmia, atherosclerosis of the coronary artery. |
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2. Has a doctor diagnosed you with any obstructive pulmonary disease?
Examples include: asthma, interstitial lung disease, emphysema, bronchitis, cystic fibrosis. |
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3. Has a doctor diagnosed you with any form of metabolic disease?
Examples include: diabetes mellitus (type 1 or type 2), thyroid disorder, renal or liver disease. |
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| 4. Has anyone in your immediate family had any heart problems prior to age 55? |
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| 5. Have you been diagnosed by a doctor as hypertensive (high blood pressure)? |
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| 6. Have you been diagnosed by a doctor as having high cholesterol? |
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Have you been diagnosed by a doctor as having hypoglycemia? |
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| 8. Have you been diagnosed by a doctor as having high triglycerides? |
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| 9. Are you epileptic? |
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| 10. Have you ever suffered a concussion or been knocked unconscious? |
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| 11. Do you smoke (or have you quit within the last 6 months)? |
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| 12. Are you pregnant? |
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| 13. Are you pre or postnatal? |
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| 14. Do you consider yourself having a sedentary lifestyle (i.e. do you sit a large part of your day)? |
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| 15. Have you ever experienced chest pain? |
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| 16. Have you ever experienced abnormal dizziness? |
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| 17. Have you ever experienced shortness of breath (with mild exertion)? |
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| 18. Are you on any medications right now? |
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| 19. Have you been diagnosed by a doctor as having osteoporosis? |
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| 20. Do you have arthritis or joint pain? |
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| 21. Do you have any back pain or a spine disorder? |
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| 22. Have you ever had any broken bones? |
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| 23. Do you have any musculoskeletal pain/injury? |
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| 24. Are you sensitive to touch or pressure in any area? |
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| 25. Have you ever had a hernia? |
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| 26. Have you ever had surgery? |
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| 27. Do you have difficultly sleeping? |
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| 28. Do you experience poor circulation in your extremities (cold hands and feet)? |
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| 29. Do you have any gastrointestinal disorders? |
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| 30. What is your doctor’s name? |
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| 31. When was your last complete physical check-up? |
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| Or you may drop us an email at: fit@columbiabootcamp.com |
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