Online Waiver – Part 2 (PARQ) We would love to hear from you! Please fill out the form below. Step 1 of 5 20% Physical Activity Readiness Questionaire/WaiverLast Name*Please re-enter your Last NameFirst Name*Please re-enter your First NameEmail*Please re-enter your e-mail address Physical Activity Readiness Questionnaire (PAR-Q)Regular CrossFit training is fun and healthy. More and more people participate in CrossFit workouts each week. CrossFit is based upon constantly varied, functional movements, executed at high intensity. It is very safe and we have CrossFit training for people from age 4 to 70. However, some people should check with their doctor before they start becoming more physically active. If you are planning to start doing CrossFit workouts, begin by answering the eight questions below. The PAR-Q will tell you if you should check with a doctor before you start. Common sense is your best guide when you answer these questions. Please read the questions carefully and answer each one honestly by checking YES or NO.What is your current activity level?*Sedentary (little or no exercise)Lightly active (light exercise/sports 1-3 days/week)Moderately active (moderate exercise/sports 3-5 days/week)Very active (hard exercise/sports 6-7 days a week)Extra active (very hard exercise/sports)1. Has your doctor ever said that you have a heart condition and that you should only do physical activity recommended by a doctor?*YesNoPlease Explain.2. Do you feel pain in your chest when you do physical activity?*YesNoPlease Explain.3. In the past month, have you had chest pain when you were not doing physical activity?*YesNoPlease Explain.4. Do you lose your balance because of dizziness or do you ever lose conciousness?*YesNoPlease Explain.5. Do you have a bone or joint problem that could be made worse by a change in your physical activity?*YesNoPlease Explain.6. Is your doctor currently prescribing drugs (for example water pills) for your blood pressure or heart condition?*NoYesPlease Explain.7. Are you currently taking prescription medicines of any kind?*YesNoPlease Explain.8. Do you know of any other reason why you should not do physical activity?*YesNoPlease Explain.You answered YES to one or more of the questionsTalk with your doctor by phone or in person BEFORE you start CrossFitting, or BEFORE you have a fitness appraisal. Tell your doctor about the PAR-Q and which questions you answered YES. You may be able to do any activity you want - as long as you start slowly and build up gradually. Or, you may need to restrict your activities to follow those which are safe for you. Talk with your doctor about the kinds of activities you wish to participate in and follow his/her advice. We'll scale the workouts to your ability and skill level at all times, or we may have you sit out if we do not feel that it is safe for you to do the CrossFit workout.You answered NO to all of the questionsIf you answered NO honestly to all the PAR-Q questions, you can be reasonably sure that you can start training using CrossFit methods. Your workouts will be scaled until you reach a level of fitness where your trainers feel you can participate in full CrossFit workouts.When to delay becoming more activeIf you are not feeling well because of a temporary illness such as a cold or a fever - wait until you feel better. Please note: If your health changes so that you then answer YES to any of the above questions, tell your CrossFit trainer and ask whether you should change your physical activity plan. Photography and Video ReleaseParticipants involved in any activities offered by CrossFit DoneRight may be photographed or videotaped during training. The undersigned hereby consents to the use of my photographs and/or videos without compensation, on the CrossFit DoneRight website or in any editorial, promotional or advertising material produced and/or published by CrossFit DoneRight.Initials*Enter initial to accept the photography/video release above Informed Consent/Assumption of RiskI am aware that there are significant risks involved in all aspects of physical training I understand that the reaction of the heart, lungs and vascular system to exercise cannot always be predicted with accuracy. I understand that there is a risk of certain abnormal changes occurring during or following exercise which may include abnormalities of blood pressure or heart rate; chest, arm or leg discomfort; transient light-headedness or fainting; and in rare instances, heart attack, stroke or even death. understand that the programs and classes offered by Bacs Fitness, LLC dba CrossFit DoneRight are of a nature and kind that are extremely strenuous and can/may push me to the limits of my physical abilities. 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. I am aware that any of these above mentioned risks may result in serious injury or death to myself and or my partner(s). Initials*Initial above that you accept and understand the statement above.I willingly assume full responsibility for any and all risks that I am exposing myself to as a result of my participation in Bacs Fitness, LLC dba CrossFit DoneRight programs/classes and accept full responsibility for any injury or death that may result from participation in any activity, class or physical fitness program. I herby certify that I know of no medical problems that would increase my risk of illness and injury as a result of participation in a fitness program designed by Bacs Fitness, LLC dba CrossFit DoneRight. With my full understanding of the above information, I agree to assume any and all risk associated with my participation in Bacs Fitness, LLC dba CrossFit DoneRight programs/classes.Initials*Initial above that you accept and understand the statement above.By signing this document, I acknowledge that I have voluntarily chosen to participate in a program of progressive, physical exercise. By signing this document, I acknowledge being informed of the strenuous nature of the program and the potential for unusual, but possible, physiological results including, but not limited to, abnormal blood pressure, fainting, heart attack, or death. By signing this document, I assume all risk for my health and well-being and hold Bacs Fitness, LLC dba CrossFit DoneRight, as well as its owners, employees, and other authorized agents including independent contractors, harmless there from. ~ understand that questions about exercise procedure and recommendations are encouraged and welcome~Initials*Initial above that you accept and understand the statement above.Waiver and ReleaseI fully understand that my personal exercise program may be strenuous and I choose to participate voluntarily. I accept all responsibility for my health and any results, injury or mishaps that may affect my well-being or health in any way. I waive any claims, demands, causes of action or any claims for relief whatsoever against, and release Bacs Fitness, LLC dba CrossFit DoneRight (as well as any of its owners, employees, or other authorized agents, including independent contractors) from any and all liability, claims and/or causes of action that I may have for injuries or other damages, arising out of participation in Bacs Fitness, LLC dba CrossFit DoneRight activities, including, but not limited to the personal training, nutritional programs and programs/classes.Initials*Initial above that you accept and understand the statement above. Submit FormIf your health status changes, please let a coach know or contact us at email@example.com. BAC's Fitness/CrossFit DoneRight assumes no liability for persons who undertake physical activity, and if in doubt after completing this questionnaire consult your doctor prior to physical activity. Please sign below indicating the following: I have read, understood and completed this questionnaire. Any questions I had were answered to my full satisfaction. Indemnification: I recognize that there is risk involved in the types of activities offered by Bacs Fitness, LLC dba CrossFit DoneRight. Therefore I accept financial responsibility for any injury that I may cause either to myself 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 Bacs Fitness, LLC dba CrossFit DoneRight, 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 Bacs Fitness, LLC dba CrossFit DoneRight. Choice of Law: The laws of the state of Maryland shall apply to any and all matters arising out of any claim. I agree that any action brought against Bacs Fitness, LLC dba CrossFit DoneRight must be decided in the courts of Montgomery County, Maryland. I have fully read and fully understand 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. I have carefully read this Agreement and fully understand its contents. I am aware that this is a release and waiver and sign knowingly, voluntarily and of my own free will. Participants Full Name*Today's Date* Participants Signature* PhoneThis field is for validation purposes and should be left unchanged.