Church Participant Agreement/Waiver

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Name
Email
  Please fill in the name of the church you are participating with below.
Church
  Please fill in your information below.
Phone
Address
Zip
You are signing up to become a participant of The Staten Island Slim Down. This will not qualify you to win the awarded cash and prizes. Please be aware that in order to qualify you will need to sign up as a CONTESTANT. Signing up as a perticipant will entitle you events, free coaching and allow you to participate in the Staten Island Slim Down discreetly.
During the exercise program in conjunction with The Staten Island Slim Down every effort should be made to assure your safety. However, as with any exercise program, there are risks, including increased heart stress and the chance of musculoskeletal injuries. In volunteering to participate in this exercise opportunity, you agree that, to your knowledge you have no limiting physical conditions or disability that would preclude an exercise program.
A physician's examination is recommended for all participants with any exercise restrictions, including any heart problems, high blood pressure, chest pain, dizziness, relevant surgeries, diabetes, asthma, epilepsy, arthritis or significant injury to any part of the body. By signing, acknowledging or completing this form, you accept full responsibility for your own health and well-being and you acknowledge an understanding that no responsibility is assumed by The Staten Island Slim Down (Staten Island Slim Down, Inc. and its other affiliates and sponsors) or any other related agency or instructor.
It is recommended that you consult your medical professional before beginning any diet, weight loss or exercise program.

The Staten Island Slim Down (Staten Island Slim Down, Inc. and its other affiliates and sponsors) are released from any liability now or in the future for conditions that may result from participation in any on-site exercise program including but not limited to:   heart attacks, muscle strains, muscle pulls, muscle tears, broken bones, shin splints, heat exhaustion, injuries to the knees, injuries to the back, injuries to feet or any other illness or soreness that may occur, including death.
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I hereby affirm that I have read and fully understand the above statements. I also acknowledge that submitting this form is confirmation of my identity and that I am in full agreement with all aspects of The Staten Island Slim Down contestant and participation.
As a final confirmation of your agreement please re-type your full name below:
Full Name

FREE Coaching

The Contest

Win $1000's in cash/prizes for having the Staten Island Slim Down's most inspiring transformation. Entering the contest is FREE of charge.

Your Trainer

Tony Books Avilez
Tony Books Avilez has been a fitness pro since 1995 and is the owner and operator of Staten Island Boot Camp and Personal Training.

Staten Island Slim Down is powered by a not-for-profit organization developed for the purpose of providing Staten Islanders with information, inspiration, strategies, tactics and tools. Along with our sponsors it is our sole intention to assist in the process of personal development of all participants with the provision of all resources FREE of charge.