Explanation of Procedure
I understand that I will be screen to determine my eligibility level of function, mobility, general cardio, respiratory and muscular fitness and personal fitness mobility goals. This information will be used by Reneu Health Staff to make recommendations concerning which PWR! Moves classes/ programs would be most appropriate to help me achieve my goals. I understand that Reneu Health PWR! Moves classes programs are not a substitute for medical rehabilitation programs and are not eligible for insurance reimbursement.
Confidentiality and Use of Personal Information
I have been informed that personal information obtained in the intake or through my participation in the PWR! Moves Classes/ Programs will be treated as privileged and confidential and will consequently not be released or revealed to any person without my express consent.
Risks
I understand risks may be associated with participation in the exercise program that requires physical exertion including injury to the musculoskeletal system and in rare cases heart attack or death. I further understand that a physician's release to participate in this exercise program is recommended and that if I have any risk factors, a physician's release will be required before I can participate in the PWR! Moves classes/ programs. I realize that every effort will be made to minimize risks and that all instructors and qualified staff will follow establish safety procedures to reduce falls and injury and will have appropriate first day of training.
Release/ Waiver
in the event that I am injured while voluntarily participating in PWR! Moves classes or programs, I agree to hold harmless, wave and release RENEU HEALTH or their employees, agents, or representatives from any responsibility, liabilities, demands, or claims of any kind arising out of my participation. This includes all injuries incurred as a result of a) use of any equipment, products and facility amenities, b) the sudden unforeseen malfunctioning of any equipment, c) instruction or supervision, and d) slipping and/or falling while in the clinic, or on the clinic premises, including adjacent sidewalks and parking areas regardless of negligence.
My signature below indicates that I have read this waiver and release and its entirety and fully understand that it is a release of liability. I voluntarily agree to participate in the PWR! Moves classes/programs and acknowledge that I have provide an accurate account of all of my injuries or medical conditions during the intake as documented in the medical history questionnaire
