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INFORMED CONSENT 

INFORMED CONSENT FOR PARTICIPATION IN THE SOAR ATHLETIC TRAINING PROGRAM

NAME OF ATHLETE:      

DATE:

LEGAL GUARDIAN NAME:      

DATE:

1. PURPOSE AND EXPLANATION OF PROCEDURE 

I/we hereby consent to voluntarily engage in an acceptable plan of athletic performance training.  I/we also give consent to be placed in SOAR athlete training program activities which are recommended for improvement of the athlete’s overall athleticism. The levels of exercise the athlete performs will be based upon cardiorespiratory (heart and lungs) and muscular fitness. I/we understand that the athlete may be required to undergo a fitness assessment prior to the start of the athlete training program in order to evaluate and assess the athlete’s present level of fitness. I/we also understand that the fitness assessment could include testing of my muscular strength, endurance, power, flexibility, balance, body composition, and other athlete assessments.

The athlete will be given exact personal instructions regarding the amount and kind of exercise that should be done while working out. A professionally trained personal fitness trainer will provide leadership to direct activities, monitor performance, and otherwise evaluate effort. I/we understand that the athlete is expected to attend every session and to follow staff instructions regarding exercise and other health and fitness regarded programs. If the athlete is taking prescribed medications, I/we have already informed the program staff and further agree to so inform them promptly of any changes which the athlete’s doctor or I/we have made regarding use of these. The athlete will be given the opportunity for periodic assessment and evaluation at regular intervals after the start of the program.  

I/we have been informed that during participation in the above-described athlete training program, the athlete will be asked to complete the physical activities unless symptoms such as fatigue, shortness of breath, chest discomfort or similar occurrences appear.  At this point, the athlete will be advised that it is his/her complete right to decrease or stop exercise and that it is his/her obligation to inform the personal fitness training program personnel of any symptoms, should any develop.  

I/we understand that during the performance of exercise, a personal fitness trainer may periodically monitor the athlete’s performance and, perhaps measuring pulse, blood pressure, or assess feelings of effort for the purposes of monitoring progress. I/we also understand that the personal fitness trainer may reduce or stop the exercise program when any of these findings indicate that this should be done for my safety and benefit. 

I/we also understand that during the performance of the athlete’s personal fitness training program physical touching and positioning of the athlete’s body may be necessary to assess my body composition, muscular, and bodily reactions to specific exercises, as well as to ensure that the athlete is using proper technique and body alignment.  I/we expressly consent to physical contact for the stated reasons above.  

2. RISKS 

It is my/our understanding and I/we have been informed that there exists the remote possibility during exercise of adverse changes including, but not limited to, abnormal blood pressure, fainting, dizziness, disorders of heart rhythm, and in very rare instances heart attack, stroke, or even death. I/we further understand, and I/we have been informed that there exists the risk of bodily injury including, but not limited to, injuries to the muscles, ligaments, tendons, and joints of the body. Every effort, I/we have been told, will be made to minimize these occurrences by proper staff assessments of the athlete’s condition before each personal fitness training session, staff supervision during exercise and by the athlete’s own careful control of exercise efforts. I/we fully understand the risks associated with exercise, including the risk of bodily injury, heart attack, stroke or even death, but knowing these risks, it is the athlete’s/legal guardian’s desire to participate as herein indicated.   

3. BENEFITS TO BE EXPECTED

I/we understand that this program will benefit my overall health and fitness as well as my athletic ability. I/we recognize that involvement in the athlete training sessions will allow the athlete to learn proper ways to perform conditioning exercises, use fitness equipment and regulate physical effort.  These experiences should benefit the athlete by indicating what physical limitations may affect the athlete’s ability to perform various physical activities. I/we further understand that if the athlete closely follows the program instructions, the athlete will likely improve his/her exercise capacity, fitness level, and athletic ability after a period of 6-10 weeks. 

4. CONFIDENTIALITY AND USE OF INFORMATION 

I/we have been informed that the information which is obtained in this athlete training program will be treated as privileged and confidential and will consequently not be released or revealed to any person, to the use of any information which is not personally identifiable with the athlete for research and statistical purposes so long as same does not identify the athlete or provide facts which could lead to   identification.  Any other information obtained, however, will be used only by the program staff to evaluate my exercise status or needs. I/we also understand and grant permission to SOAR and the SOAR employees to take periodic pictures that will be used for publicity, advertising, or any other commercial purposes.

Notice to Participants, Parents and Staff Regarding the Use of Video Surveillance on SOAR Property

We would like to inform you that as part of our commitment to ensuring the safety and security of our facility, participants, and employees, we will be implementing camera surveillance on our premises. One camera can be found on the northwest corner wall, with the primary purpose of monitoring and safeguarding the environment. The camera will be visible and placed openly, serving as a deterrent to potential threats and enhancing overall security measures. It's important to note that the cameras will only be used for security purposes and will not be utilized for any other form of monitoring or recording. Your privacy and confidentiality remain of utmost importance to us, and we assure you that all recorded footage will be securely stored and accessed only by authorized personnel when necessary. By continuing to participate in activities within our facility, you acknowledge and consent to the presence of camera surveillance for the safety and security of all individuals involved. Participants, parents, staff, and visitors agree to indemnify and save harmless SOAR and its owners, agents, successors, and assigns, from any and all claims and liability for damages, losses or expenses of any sort arising from the lawful making of such recordings and their lawful and appropriate use.  SOAR and its owners exclusively own all rights to any recordings made, regardless of the form in which they are produced or used.

If you have any questions or concerns regarding this matter, please do not hesitate to contact us.

5. INQUIRIES AND FREEDOM OF CONSENT 

I/we have been given an opportunity to ask questions as to the procedures.   

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Waiver and Release

I, as parent or legal guardian of the minor/child(ren) listed below agree that the listed minor/child(ren) will abide by the rules of SOAR, including the completion of a policies and procedures form and health history information prior to their participation in any physical activities at SOAR. I agree that all use of SOAR’s facilities, programs, and services that are undertaken by the listed minor/child(ren) will be done so at my sole risk and that SOAR shall not be liable for any injuries, accidents, or death occurring to my minor/child(ren), including those caused by the negligence of SOAR but excluding gross negligence of SOAR, arising either directly or indirectly out of participation in, or use of, SOAR’s facilities, programs, and services. I, as parent or legal guardian for the listed minor/child(ren) and on behalf of them, their parents or legal guardians, their executors, administrators, heirs, and assigns, do hereby expressly release, discharge, waive, relinquish, and covenant not to sue SOAR, its affiliates, officers, directors, employees, and agents for all such claims, demands, injuries, damages, or causes of action, including those resulting from SOAR’s negligence excluding gross negligence, arising either directly or indirectly out of their participation in, or use of, SOAR’s facilities, programs, and services.

I declare that I have completed SOAR’s policies and procedures and health information form for my minor/child(ren) and declare that they are physically able to participate in physical activity. Furthermore, I acknowledge, that SOAR has advised me to obtain a physician’s clearance in the event the answers on the health information form indicates that they should not participate in a program of physical activity without a physician’s clearance, or if I am unsure of the listed minor/child(ren)’s physical healthy yet maintain that he/she is physically capable of pursuing physical activity at SOAR without such steps being taken or has done so. 

I/we have read this Informed Consent form and Waiver and Release and fully understand its terms, I/we understand that I/we have given up substantial rights by signing it, and sign it freely and voluntarily, without inducement. 

Participant Information

Participant’s Name (Printed):    

DOB:     Age:

Phone:

IF UNDER THE AGE OF 18, PLEASE PROVIDE LEGAL GUARDIAN CONSENT AND INFORMATION