Polsky's Strength & Conditioning - Waiver & Health Info

Express assumption of risk:

I, the undersigned, am aware that there are significant risks involved in all aspects of physical training. These risks include, but are not limited to: falls which can result in serious injury or death; injury or death due to negligence on the part of myself, my training partner, or other people around me; injury or death due to improper use or failure of equipment; strains and sprains. I am aware that any of these above mentioned risks may result in serious injury or death to myself and or my partner(s). I willingly assume full responsibility for the risks that I am exposing myself to and accept full responsibility for any injury or death that may result from participation in any activity or class while at, or under direction of Polsky's Strength & Conditioning. I acknowledge that I have no physical impairments, injuries, or illnesses that will endanger me or others.

In consideration of the above mentioned risks and hazards and in consideration of the fact that I am willingly and voluntarily participating in the activities offered by Polsky's Strength & Conditioning, I, the undersigned hereby release Polsky's Strength & Conditioning, their principals, agents, employees, and volunteers from any and all liability, claims, demands, actions or rights of action, which are related to, arise out of, or are in any way connected with my participation in this activity, including those allegedly attributed to the negligent acts or omissions of the above mentioned parties. This agreement shall be binding upon me, my successors, representatives, heirs, executors, assigns, or transferees. If any portion of this agreement is held invalid, I agree that the remainder of the agreement shall remain in full legal force and effect. If I am signing on behalf of a minor child, I also give full permission for any person connected with Polsky's Strength & Conditioning to administer first aid deemed necessary, and in case of serious illness or injury, I give permission to call for medical and or surgical care for the child and to transport the child to a medical facility deemed necessary for the well being of the child.

The participant recognizes that there is risk involved in the types of activities offered by Polsky's Strength & Conditioning. Therefore the participant accepts financial responsibility for any injury that the participant may cause either to him/herself or to any other participant due to his/her negligence. Should the above mentioned parties, or anyone acting on their behalf, be required to incur attorney’s fees and costs to enforce this agreement, I agree to reimburse them for such fees and costs. I further agree to indemnify and hold harmless Polsky's Strength & Conditioning, their principals, agents, employees, and volunteers from liability for the injury or death of any person(s) and damage to property that may result from my negligent or intentional act or omission while participating in activities offered by Polsky's Strength & Conditioning, at the main building or abroad. This includes but is not limited to parks, recreational areas, playgrounds, areas adjacent to main building, and/or any area selected for training by Polsky's Strength & Conditioning.

I have read and understood the foregoing assumption of risk, and release of liability and I understand that by signing it obligates me to indemnify the parties named for any liability for injury or death of any person and damage to property caused by my negligent or intentional act or omission. I understand that by signing this form I am waiving valuable legal rights.

Physical activity improves your physical and mental health. Even small amounts of physical activity are good, and more is better.
For almost everyone, the benefits of physical activity far outweigh any risks. For some individuals, specific advice from a Qualified Exercise Professional (QEP – has post-secondary education in exercise sciences and an advanced certification in the
area) or health care provider is advisable. This questionnaire is intended for all ages – to help move you along the path to becoming more physically active.

The following questions will help to ensure that you have a safe physical activity
experience.

PLEASE RECORD ALL YES ANSWERS IN THE TEXT BOX BELOW.

1 Have you experienced ANY of the following (A to F) within the past six months?

A A diagnosis of/treatment for heart disease or stroke, or pain/discomfort/pressure
in your chest during activities of daily living or during physical activity?

B A diagnosis of/treatment for high blood pressure (BP), or a resting BP of 160/90 mmHg or higher?

C Dizziness or lightheadedness during physical activity?

D Shortness of breath at rest?

E Loss of consciousness/fainting for any reason?

F Concussion?

2 Do you currently have pain or swelling in any part of your body (such as from an injury, acute flare-up of arthritis, or back pain) that affects your ability to be physically active?

3 Has a health care provider told you that you should avoid or modify certain types of physical activity?

4 Do you have any other medical or physical condition (such as diabetes, cancer, osteoporosis, asthma, spinal cord injury) that may affect your ability to be physically active?
(ANSWER ABOVE QUESTIONS BELOW IN FIRST AND 2 QUESTION OPTIONS)

Answer the following questions to assess how active you are now.

1 During a typical week, on how many days do you do moderate- to vigorous-intensity aerobic physical activity (such as brisk walking, cycling or jogging)? DAYS/WEEK

2 On days that you do at least moderate-intensity aerobic physical activity (e.g., brisk walking), for how many minutes do you do this activity? MINUTES/WEEK

For adults, please multiply your average number of days/week by the average number of minutes/day: MINUTES/DAY

(ANSWER THE ABOVE QUESTIONS BELOW IS SECOND QUESTION OPTION)

If my health changes, I will complete this questionnaire again.
DECLARATION

Canadian 24-Hour Movement Guidelines recommend that adults accumulate at least 150 minutes of moderate- to vigorous-intensity physical activity per week. For children and youth, at least 60 minutes daily is recommended. Strengthening muscles and bones at least two times per week for adults, and three times per week for children and youth, is also recommended

Increase your physical activity gradually so that you have a positive experience. Build physical activities that you enjoy into your day (e.g., take a walk with a friend, ride your bike to school or work) and reduce your sedentary behavior (e.g., prolonged sitting).
If you want to do vigorous-intensity physical activity (i.e., physical activity at an intensity that makes it hard to carry on a conversation), and you do not meet minimum physical activity recommendations noted above, consult a Qualified Exercise
Professional (QEP) beforehand. This can help ensure that your physical activity is safe and suitable for your circumstances. Physical activity is also an important part of a healthy pregnancy. Delay becoming more active if you are not feeling well because of a temporary illness.

1. Acknowledgment of Activity

I understand that participation in the PSC Run Club involves voluntary physical activity, including but not limited to running, jogging, walking, and related outdoor fitness activities organized by Polsky’s Strength & Conditioning (PSC).

I acknowledge that these activities take place outdoors and may involve:
• Uneven surfaces (sidewalks, roads, trails)
• Traffic and road crossings
• Weather conditions (heat, humidity, rain, cold)
• Physical exertion and fatigue

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2. Assumption of Risk

I understand and acknowledge that participation in the PSC Run Club carries inherent risks, including but not limited to:
• Slips, trips, and falls
• Muscle strains, sprains, or other injuries
• Dehydration, heat exhaustion, or other medical events
• Accidents involving vehicles, cyclists, pedestrians, or animals

I freely and voluntarily assume all risks, known and unknown, associated with my participation.

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3. Release of Liability

In consideration of being permitted to participate in the PSC Run Club, I hereby release, waive, and discharge:

Polsky’s Strength & Conditioning (PSC), its owners, directors, officers, coaches, employees, contractors, volunteers, and representatives

from any and all liability for any loss, damage, injury, or expense that I may suffer as a result of my participation, including any claims arising from negligence, to the fullest extent permitted by law.

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4. Nature of the Run Club

I understand that:
• The PSC Run Club is a community-based group run, not individualized coaching or supervision
• I am responsible for selecting a pace and distance appropriate to my fitness level
• I may stop or modify my participation at any time

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5. Health & Medical Acknowledgment

I confirm that:
• I am physically able to participate in this activity
• I have no medical condition that would prevent safe participation, or I have consulted a medical professional
• I accept full responsibility for my health and wellbeing during participation

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6. Emergency Medical Consent

In the event of illness or injury, I authorize PSC and its representatives to obtain medical assistance on my behalf if deemed necessary. I agree to be responsible for any associated costs.

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7. Rules & Conduct

I agree to:
• Follow all safety instructions provided by PSC
• Obey traffic laws and use caution at all times
• Respect other participants, pedestrians, and public spaces

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8. Insurance Acknowledgment

I understand that PSC may not provide personal accident or health insurance coverage for participants, and I am responsible for my own insurance if desired.

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9. Media Release (Optional – you can remove if you want)

I grant permission to PSC to use photos or videos taken during Run Club activities for promotional purposes.

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10. Governing Law

This agreement shall be governed by and interpreted in accordance with the laws of the Province of Ontario and the laws of Canada applicable therein.

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11. Acknowledgment & Signature

I confirm that I have read, understood, and agree to this waiver and release of liability. I understand that by signing this document, I am giving up certain legal rights.