Registration

Registration

Elite Diesel Program - For Men

Saturday 9:15am
Program*
Total
$ 0.00 CAD
Client Information
Name*
Address*
Street AddressCityPostal Code
Telephone*
Email*
Date of birth*
MM
DD
YYYY
Gender*
- Male
- Female
T-Shirt Size*
How Did You Hear About Elite Performance Academy?*
Emergency Contact Information
Name*
Telephone*
Par-Q and You
Regular physical activity is fun and healthy, and increasingly more people are starting to become more active every day. Being more active is very safe for most people. However, some people should check with their doctors before they start becoming much more physically active. If you are planning to become much more physically active than you are now, start by answering the seven questions in the box below. If you are between the ages of 15 and 69, the PAR - Q will tell you if you should check with your doctor before you start. If you are over 69 and you are not used to being very active, check with your doctor.

Common sense is your best guide when you answer these questions. Please read the questions carefully and answer each one honestly: check if YES, leave blank for NO.
Medical Conditions*
- Has your doctor ever said that you have a heart condition and that you should do only physical activity recommended by a doctor?
- Do you feel pain in your chest when you do physical activity?
- In the past month, have you had chest pain when you were not doing physical activity?
- Do you lose your balance because of dizziness or do you ever lose consciousness?
- Do you have a bone or joint problem that could be made worse by a change in your physical activity?
- Is your doctor currently prescribing drugs (for example, water pills) for your blood pressure or heart condition?
- Do you know of any other reason that you should not do physical activity?
- None of the above
If you checked off one or more questions: Talk with your doctor by phone or in person BEFORE you start becoming much more physically active 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 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. Find out which community programs are safe and helpful for you.

If you answered NO honestly to all PAR-Q questions: You can be reasonably sure that you can start becoming much more physically active. Begin slowly and build up gradually - this is the safest and easiest way to go. You can also take part in a fitness appraisal - this is an excellent way to determine your basic fitness so that you can plan the best way for you to live actively.

Delay becoming much more active if: you are not feeling well because of a temporary illness such as a cold or a fever - wait until you feel better; or if you are or may be pregnant - talk to your doctor before you start becoming more active.

Please note: If your health changes so that you then answer YES to any of the above questions, tell your fitness or health professional. Ask whether you should change your physical activity plan.

INFORMED USE OF THE PAR - Q: The Canadian Society for Exercise Physiology, Health Canada, and their agents assume no liability for persons who undertake physical activity, and if in doubt after completing this questionnaire, consult your doctor prior to physical activity.

Any questions I had were answered to my full satisfaction.

I have read, understood, and completed this questionnaire.
Informed Consent and Release Form
I acknowledge that my participation in Elite Performance Academy’s strength and fitness programs, assessments, sport-specific skills camps, and any other programs or activities, is completely voluntary.

I understand that there are potential risks associated with any type of physical activity (i.e. weight-training, speed training, cardiovascular exercise, flexibility exercise, competitive sports, the use of exercise equipment...) and I assume willfully those risks.

I agree that I alone am responsible for assessing whether my participation poses any problem or hazard to me. To assist me in assessing this I agree to properly utilize any questionnaires and/or other recommended assessment mechanisms.

I agree to immediately inform Elite Performance Academy or Elite Football Academy Staff should there be any change in my medical condition, as this may require another fitness assessment and/or changes to my exercise program to ensure its continuing suitability, or termination of participation.

In consideration of being allowed to participate in the activities and programs of the Elite Performance Academy and the use of its exercise or sports equipment and machinery, I do hereby waive, release and forever discharge the Elite Performance Academy, Elite Football Academy, its officers, employees, agents or contractors and all others from any responsibility or liability from injuries or damages (including death) resulting from my participation in the above mentioned fitness activities.

I understand that Elite Performance Academy believes in the authenticity of using their own athletes on their website and in any promotional material they produce. I hereby grant permission to the rights of my image, likeness and sound of my voice as recorded on audio or video tape without payment or any other consideration.

Sign below only when you have read and thoroughly understood this Informed Consent and Release Form Parent or Guardian signature required if under 18 years of age.
Signature*
Date*

Social Networking

FACEBOOK

COACH PAT ON TWITTER

Coach Pat Woodcock

There comes a time when everyone must decide for themselves if they are going to live up to everything that they... http://t.co/xulzXOd2kk - posted 1 week ago
RT @DGaborWR: Shoutout to the man, the qb @tyscott96 #followhim #footballfamily - posted 1 week ago

COACH DONNIE ON TWITTER

Coach Donnie Ruiz

If you were Blessed to wake up today, Then Your opportunity to Improve from yesterday, is waiting for U to make your decision. #BeElite #A1 - posted 1 week ago
#EliteD2D boyz......... Nuff said! #Now Rest - posted 1 week ago

Recent Blog Posts

ELITE "DETERMINATION 2 DOMINATION" (D2D) May 15, 2013
Camp Recap - Elite Football Academy 2013 April 1, 2013
Elite Performance Academy selected to coach at CBC Hockey Nation February 20, 2013
Elite Eats - Blueberry Coconut Pecan Breakfast Cookies January 30, 2013

CONTACT US

Telephone

Elite Athlete Development: 613.447.5383
Elite Personal Training: 613.889.3443

Email

info@eliteperformanceacademy.ca

Address

93 Hines Road
Kanata, Ontario
K2K 2M5

Elite Diesel Program - For Men

Saturday 9:15am

Client Information

Emergency Contact Information

Par-Q and You

Informed Consent and Release Form