Informed Consent Form

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Informed Consent Participation in all types of physical activities has certain inherent risks and, regardless of the care taken, it is impossible to eliminate all of the risks involved in physical activity. Since this activity is voluntary we cannot exclude you from an activity, but a doctor’s approval is always recommended before starting any type of physical activity. While all activities are reasonably safe, some elements of risk can’t be completely removed from physical activity. A variety of injuries may occur to you as a participant but are not limited to: 1. Minor injuries such as muscle soreness 2. More serious injuries such as strains and sprains 3. Catastrophic injuries such as heart attack and death To help reduce the likelihood of injury to you, participants are expected to adhere to the following rules: All participants are encouraged to attend scheduled sessions. All participants are encouraged to wear proper clothing and footwear. All participants are expected to report any problems experienced during the session to the wellness committee so that proper action can be taken to help with the situation. I agree to the following preceding safety rules at all times during my involvement in the wellness activities. Further, I agree to report any unsafe conditions to the wellness committee. I have read the preceding information and it has been explained to me. I know, and understand the risks associated with participation as a volunteer in this activity. I am voluntarily participating in the activity. In doing so, I am assuming all the inherent risks of the activity. I understand that in an event of a medical emergency, emergency services will be called to assist and I will be financially responsible for any expenses involved.

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Signature of Participant

Wellness Committee

Date

Date


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