I have voluntarily enrolled in a program of progressive exercise. The program is designed to place gradually increased workload on the heart, lungs, muscles and bones to help improve their function. I understand that participation in such a program may be associated with some risks. These risks may include but are limited to muscle soreness, fainting, disorders of the heartbeat, abnormal blood pressure, and in very rare instances heart attack. To the best of my knowledge I do not have any limiting physical conditions or disabilities that would preclude an exercise program. I release everyone who has designed, promoted or conducted the Strong Bodies program from all claims or liabilities whatsoever resulting from my participation in this program. I assume all risks and responsibilities for any injury, damage, or any other adverse event that may result from my participation in this program. Before I begin this program I understand that a pre-exercise assessment and physician screening consent form may be required. I understand that each person may react differently to these fitness activities and these reactions cannot be predicted with complete accuracy. I will inform the Program Leader and/or my health care provider if I experience any unusual symptoms. Signature by entering your name below and dating. *