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SIGN WAIVERS HERE:

Child and Adult Waivers Below:

Find the waiver that applies to you - fill out and press submit. Please reach out if there are any issues

Child Waiver

Cherry Picker Movement Club Fitness Parent / Guardian Waiver and Release Form

You agree that you are aware that the child named below will be engaging in physical exercise involving various sports, coordination, events and general fitness training, which could cause injury to him or her. The location of these activities will take place at:

You understand that your child is voluntarily participating in these activities and is assuming all risks of injury that may result from engaging in any exercise program or sport related even including skipping, tripping or falling. You also hereby agree to waive any claims or rights that you might otherwise have to sue Asha Labreche and the Cherry Picker Movement Club, the centre, our employees, owners, offices or agents for any injury that might occur. You understand that we will make no evaluation or recommendation as to whether or not the child is capable or deemed physically fit to engage in any activity. If the child has any physical or mental condition that my impair his or her ability to engage in any of the club activities. It is your responsibility to obtain a physicians release statement if there are any concerns regarding the health of your child. It is recommended that you consult a physician or your paediatrician prior to your child participating in any physical exercise program. 

Child's Birthday
Date
My child has no known physical or mental health conditions that will prevent them from fully participating in this camp.
Yes
No

Adult Waiver

Cherry Picker Movement Club Fitness Waiver and Photography Release Form

Birthday
Do you prefer text or phone call?

Par-Q and YOU Section

Please answer questions below honestly

Has your doctor said you have a heart condition and that you should only do physical activity recommended by a doctor?
Yes
No
Do you feel pain in your chest when you do physical activity?
Yes
No
In the past month, have you had chest pain when you were NOT doing physical activity?
Yes
No
Do you lose your balance because of dizziness or do you ever lose consciousness?
Yes
No
Do you have a bone or joint problem (ie back, knee or hip) that could be made worse by physical activity?
Yes
No
Is your doctor currently prescribing drugs (ie water pills) for your blood pressure or heart condition?
Yes
No

YES to ONE or more questions:

If you answered YES to ON or more of the above questions: please talk to your doctor BEFORE your movement class. Tell your doctor about the PAR-Q questionnaire and what questions you answered yes to.

NO to ALL questions:

If you answered NO to ALL questions and are just beginning you are just at the beginning of becoming physically active : consider taking part in a personal assessment session - it is an excellent way to determine your basic fitness so that you can plan for the best way to live actively. It is also recommended to have you blood pressure evaluated. If you are reading over 144/94 talk to your doctor before becoming more physically active.

Did you answer YES to ANY of the above?

FITNESS WAIVER & RELEASE FORM

I understand that there is a certain amount of risk associated with any physical activity, and both benefits and risks associated with any exercise program, and The Cherry Picker Movement Club and its employees harmless for my activities. If applicable, I have obtained medical clearances needed to use the equipment and/or start an exercise routine. I agree that if I engage in any physical exercise or activity, or use any Cherry Picker Movement Club equipment on the premises or at my home via online training, I do so at my own risk. I agree that I am voluntarily participating in these activities and the use of these facilities, premises or at my home. I assume all risks of injury, illness, or death. In addition, the Cherry Picker Movement Club is not responsible for any loss of my personal property. This waiver and release of liability includes, without limitation, all injuries that may occur as a result of: (a) my use of all amenities and equipment in the facility or at my home via online training/videos and my participation in any activity, class, program, personal training or instruction, (b) the sudden and unforeseen malfunctioning of any equipment and (c) our instruction, training, and supervision. I acknowledge that I have carefully read this “Waiver and Release” and fully understand that it is a release of liability. I expressly release and discharge The Cherry Picker Movement Club, and all employees, agents, representatives, successors, or assigns, from any and all claims or causes of action, and I agree to voluntarily give up or waive any right that I may otherwise have to bring a legal action against the Cherry Picker Movement Club or its employees for personal injury or property damage.

Date

Photography Video and Release Form

I hereby grant permission to the rights of my image, likeness and sound of my voice as recorded on audio or video without payment or any other consideration. I understand that my image may be edited, copied, exhibited, published or distributed and waive the right to inspect or approve the finished product wherein my likeness appears. Additionally, I waive any right to royalties or other compensation arising or related to the use of my image or recording. I also understand that this material may be used in diverse educational settings within an unrestricted geographic area. Photographic, audio or video recordings may be used for the following purposes: - conference presentations - educational presentations or courses - informational presentations - on-line educational courses - educational videos - promotional videos By signing this release I understand this permission signifies that photographic or video recordings of me may be electronically displayed via the Internet or in the public educational setting. I will be consulted about the use of the photographs or video recording for any purpose other than those listed above. There is no time limit on the validity of this release nor is there any geographic limitation on where these materials may be distributed. This release applies to photographic, audio or video recordings collected as part of the sessions listed on this document only. By signing this form I acknowledge that I have completely read and fully understand the above release and agree to be bound thereby. I hereby release any and all claims against any person or organization utilizing this material for educational and promotional purposes.

*Leave blank if you do not consent*

Date
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