Liability and Waiver Release (2016)
Assessment/Intake Questionnaire
Athlete Questionnaire
Website developed & constructed by Bob Pates, owner, Pates Running & Racing.
Copyright  
© 2008-2016 Patesrunning.com  All Rights Reserved.
I am fully aware that participating in any exercise program can be a potentially dangerous, hazardous
activity. I am specifically aware of the potential dangers of participating in the
Pates Running & Racing
and/or
eTRAINING Personal Fitness Training Programs.

In consideration of my acceptance into the
Pates Running & Racing and/or eTRAINING Personal Fitness
Training Programs. I, the undersigned (parent or guardian if participant is under 18 years of age) intending
to be legally bound, do hereby for myself, my heirs, executors, administrators, and assigns, assume any and
all risks of participating in said training programs, and I hereby waive and release any and all rights and claims
for damages I may have against
Bob Pates, representatives, successors, and assigns for any and all
injuries, all such risks being known and appreciated by me. I hereby waive and release the above named
persons, and entities, their representatives, employees, successors, and assigns from any and all claims or
liabilities of any kind arising out of my participation in said training programs, even though these claims and
liabilities might arise out of the negligence or carelessness on the part of the persons named above. I attest
and verify that I am physically fit and prepared for the  
Pates Running & Racing and/or eTRAINING
Personal Fitness Training Programs, and that a licensed medical doctor has verified my physical condition
within the last six months.

I hereby assume full responsibility from any injury, including my death occurring while participating in, or as a
result of, my participating in the
Pates Running & Racing and/or eTRAINING Personal Fitness Training
Programs, and hereby release, waive, discharge and covenant not to sue Bob Pates, successors,
representatives, employees, assigns, or other participants in the
Pates Running & Racing and/or
eTRAINING Personal Fitness Training Programs from any and all liability to me, my personal representatives,
heirs, successors, and assigns for any loss or damage and claim or demands therefore on account of injury
to me, including my death, whether caused by their negligence or carelessness in advising me while
participating in the
Pates Running & Racing and/or eTRAINING Personal Fitness Training Programs.

You agree that this Agreement constitutes "a writing signed by You" under any applicable law or regulation.

_______________ ________________________________________
Date/Participant


_______________ ________________________________________      
Date/ Coach Bob Pates, Owner, Pates Running & Racing
P
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