Trench Powerlifting Open Registration Form Step 1 of 5 - Contact Information 20% Contact InformationName* First Last Email* Cell Phone*Home PhoneAddress* Street Address Address Line 2 City AlbertaBritish ColumbiaManitobaNew BrunswickNewfoundland & LabradorNorthwest TerritoriesNova ScotiaNunavutOntarioPrince Edward IslandQuebecSaskatchewanYukon Province Postal Code Date of Birth* Event InformationGender*FemaleMaleFemale Weight ClassFemale 43kg (sub junior/junior only)Female 47kgFemale 52kgFemale 57kgFemale 63kgFemale 72kgFemale 84kgFemale 84+kgMale Weight ClassMale 53kg (sub junior/junior only)Male 59kgMale 66kgMale 74kgMale 83kgMale 93kgMale 105kgMale 120kgMale 120+kgCPU Card Number*Powerlifting Event*NoneEquipped PowerliftingClassic PowerliftingBench Press Event*NoneEquipped Bench PressClassic Bench PressT-Shirt Size*SmallMediumLargeXLargeXXLarge Bio DetailsOccupationNumber of Years TrainingExperienceDo you have national or international experience?RecordsDo you have any provincial, national, or international records?ThanksIs there anyone you would like to thank? Electronic CommunicationsElectronic Communications ConsentPlease consent to receive electronic messages from Trench Fitness which may include announcements, invitations, event information, news, updates, service information, client customer care, and promotions from us. You can unsubscribe at any time. I Do Not ConsentI ConsentTrench Fitness Email NewsletterTrench Fitness Email Newsletter SubscriptionWe send out a helpful newsletter with the latest Trench Fitness News, Workout Tips, and Recipes approximately 4 times a year. You can unsubscribe at any time. Yes I would like to Subscribe SPA WaiverIn consideration of accepting this entry, I hereby for myself, heirs, executors, and administrators, waive and release any and all rights and claims for damages I may have against: the International Powerlifting Federation, the Canadian Powerlifting Union, the Saskatchewan Powerlifting Association, Synergy Strength and Conditioning, its sponsors and its employees, all organizers, volunteers and sponsors of this contest, from any and all actions, causes of actions, claims and demands which may arise in consequence of my participation in this contest.Do you Agree to the SPA Waiver?* Yes, I Agree Trench Fitness WaiverPlease read and agree to the following; ASSUMPTION OF RISK, RELEASE OF LIABILITY, WAIVER AND INDEMNITY AGREEMENT AND PAR-Q. PLEASE READ THIS DOCUMENT CAREFULLY. BY SIGNING THIS DOCUMENT, YOU ARE AGREEING TO WAIVE CERTAIN LEGAL RIGHTS, INCLUDING THE RIGHT TO SUE. I acknowledge and agree that: a. I will follow all instructions and directions (if any) that may be provided to me by Trench Fitness Inc. during training programs; b. I may be allowed to access Trench Fitness Inc.’s facilities at any time and, at certain times, there may be no supervision or assistance available to me. I understand that if I am injured, become unconscious, or suffer a stroke or heart attack, there may be no one to respond to my emergency and that Trench Fitness Inc. has no duty to provide any assistance to me. I will provide Trench Fitness Inc. with an honest and accurate description of my level of physical fitness, health, nutrition, use of medication, medical history, and current physical, mental, and medical condition. If I answer “yes” to one or more questions on the attached PAR-Q form, I will consult with my physician prior to commencing athletic activities with Trench Fitness Inc.. d. I consent to receive first aid and medical treatment from Trench Fitness Inc. in the event of an accident, injury or illness during athletic activity. If I have provided medication to Trench Fitness Inc., I consent to receive such medication and I consent to Trench Fitness Inc. administering such medication to me. e. Trench Fitness Inc. may videotape, audiotape, or photograph me for instructional and promotional purposes without payment of any kind to me and without further notice to me or permission from me; f. I understand that having my child(ren) present while I am using Trench Fitness Inc.’s facilities, participating in or watching Trench Fitness Inc.’s activities, or being present on Trench Fitness Inc.’s premises, is at my own risk, and that I am solely responsible for supervising my child(ren) during such times. ASSUMPTION OF RISKS I understand that by participating in the training programs provided by Trench Fitness Inc., I will be exposed to many risks, dangers and hazards which could result in physical injury, death, damages or other losses to me. Some of these risks, dangers and hazards include, but are not limited to: a. Health: overexertion, dehydration, fatigue, and various injuries caused by my lack of fitness or conditioning; b. Premises: defective, dangerous or unsafe condition of the facilities; falls; collisions with objects, equipment or persons; c. Use of Equipment: mechanical failure of the equipment; negligent design or manufacture of the equipment; the provision of or the failure by Trench Fitness Inc. to provide any warnings, directions, instructions or guidance as to the use of the equipment; failure to use or operate the equipment within my own ability; d. Advice: negligent advice regarding training programs; and e. My conduct and the conduct of others: I understand that my negligence, and the negligence of others, including the NEGLIGENCE OF Trench Fitness Inc., may increase my risk of damage, loss, personal injury or death. I understand that Trench Fitness Inc. may fail to safeguard or protect me from the risks, dangers and hazards of training programs, some of which are referred to above. Despite the risks, dangers and hazards associated with participating in training programs, and fully understanding the nature and extent of such risks, dangers and hazards, I wish to participate in training programs with Trench Fitness Inc., and I FREELY ACCEPT AND FULLY ASSUME all such risks, dangers and hazards and the possibility of personal injury, death, property damage and loss resulting from such training programs. RELEASE OF LIABILITY, WAIVER OF CLAIMS AND INDEMNIFICATION In consideration of Trench Fitness Inc. allowing me to participate in training programs and to use its equipment, facilities and services, I agree that: 1. I WAIVE ANY AND ALL CLAIMS that I now have, or may in the future have, against Trench Fitness Inc. AND I RELEASE Trench Fitness Inc. from any and all liability for any loss, damage, expense or injury (including death) that I, or my next-of-kin, may suffer as a result of my participation in training programs, DUE TO ANY CAUSE WHATSOEVER including, but not limited to: a. negligence on the part of Trench Fitness Inc.; b. breach of contract by Trench Fitness Inc.; c. breach of warranty by Trench Fitness Inc. in respect of the design, manufacture, selection, installation, maintenance or adjustment of equipment; d. breach of any statutory or other duty of care on the part of Trench Fitness Inc.; and e. the failure by Trench Fitness Inc. to safeguard or protect me from the risks associated with training programs; and 2. I WILL INDEMNIFY TRENCH FITNESS INC. FROM, AND COMPENSATE Trench Fitness Inc. FOR, any and all liability that Trench Fitness Inc. may incur for any damage, loss, expense or injury to any third party resulting from my participation in training programs. In the event that I die or become unable to make my own decisions, I agree that this Agreement will remain binding upon my heirs, next-of-kin, executors, administrators, assigns and representatives (collectively, my “Heirs”). INSURANCE: I understand that Trench Fitness Inc. does not provide me with any disability, accident, liability or medical insurance or compensation in the event that I become injured or cause personal injury or property damage to any third party while participating in training programs. JURISDICTION: This Agreement and any rights, duties and obligations as between Trench Fitness Inc. and I shall be governed by and interpreted solely in accordance with Saskatchewan law. Any litigation involving Trench Fitness Inc. and I must be brought solely within Saskatchewan and shall be within the exclusive jurisdiction of the Courts of Saskatchewan. I acknowledge that, in entering into this Agreement I am not relying on any oral or written representations or statements made by Trench Fitness Inc. with respect to the safety of training programs other than what is set forth in this Agreement. DEFINITIONS I understand that in this Agreement, the following terms have the following meanings: a. “Trench Fitness Inc.” means Crossfit Saskatoon Inc., operating under the registered business name “Trench Fitness Inc. Strength and Conditioning”, and includes its directors, owners, employees, independent contractors, trainers, instructors, agents, volunteers, servants, representatives, successors and assigns; and b. “training programs” includes all activities, programs, events, classes, and services provided, sponsored or organized by Trench Fitness Inc. including, but not limited to: fitness classes; personal training; weight training; sporting events; use of strength training and fitness conditioning equipment, machines and facilities; nutritional and dietary programs; health, wellness and fitness assessments; orientation or instructional sessions or lessons; and all other such related activities. I have read and understood this agreement, and I UNDERSTAND THAT BY CLICKING AGREE TO THIS AGREEMENT ONLINE I AM WAIVING CERTAIN LEGAL RIGHTS WHICH I OR MY HEIRS MAY HAVE AGAINST Trench Fitness Inc.. This accepts responsibility for any and all parties listed in this stated form.Do you Agree to the Trench Fitness Waiver?* Yes, I Agree Electronic Signature*Please type your full first and last name above. This is considered to be your electronic signature of both the SPA Waiver and the Trench Fitness Waiver. A Parent or Guardian must sign if you are under 18.Today's Date PhoneThis field is for validation purposes and should be left unchanged.