BCHQ Hyrox Simulation — PAR-Q & Waiver

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PARTICIPANT DETAILS

FIRST NAME *

LAST NAME *

DATE OF BIRTH *

PHONE NUMBER *

EMAIL ADDRESS *

HOME ADDRESS (INCL. POSTCODE) *

DIVISION *

DOUBLES PARTNER (IF APPLICABLE)

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EMERGENCY CONTACT

FULL NAME *

RELATIONSHIP *

PRIMARY PHONE *

SECONDARY PHONE

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PHYSICAL ACTIVITY READINESS (PAR-Q)

Answer every question honestly. If you answer YES to any question, consult your doctor before participating. The event involves 8km of running, heavy sled work, rowing, SkiErg, carries, lunges, and wall balls.

Q1

Has your doctor ever said that you have a heart condition and that you should only do physical activity recommended by a doctor?

YES

NO

Q2

Do you feel pain in your chest when you do physical activity?

YES

NO

Q3

In the past month, have you had chest pain when you were not doing physical activity?

YES

NO

Q4

Do you lose your balance because of dizziness, or do you ever lose consciousness?

YES

NO

Q5

Do you have a bone or joint problem (for example, back, knee, or hip) that could be made worse by a change in your physical activity?

YES

NO

Q6

Is your doctor currently prescribing any medication for your blood pressure, heart condition, or related health concern?

YES

NO

Q7

Do you know of any other reason why you should not take part in vigorous physical activity?

YES

NO

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MEDICAL INFORMATION

Tick any conditions that apply to you. This information is used only for participant safety on race day.

CONDITION

YES

N/A

Known cardiovascular or heart condition

Recent surgery or injury (within 6 months)

Asthma or respiratory condition

Diabetes or blood sugar condition

Epilepsy or seizure history

Known allergy (medication, latex, food)

Currently taking prescribed medication

ADDITIONAL MEDICAL INFORMATION (anything staff should know)

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LIABILITY WAIVER

The BCHQ Hyrox Simulation is a vigorous physical activity event involving running, heavy sled pushing and pulling, rowing, SkiErg, kettlebell carries, sandbag lunges, burpee broad jumps, and wall ball throws.

By signing this form, I acknowledge that participation carries inherent risks including muscular strain, joint injury, cardiovascular stress, exhaustion, and in extreme cases serious injury. I accept these risks voluntarily.

To the fullest extent permitted by law, I release, discharge, and hold harmless BC Fitness Cumbria Limited, its directors, employees, coaches, judges, and volunteers from any and all claims, losses, damages, or liabilities arising from my participation, including claims arising from negligence, except where such liability cannot lawfully be excluded.

I agree to comply with all rules and instructions set by BC Fitness HQ on the day. I understand that failure to comply may result in removal from the event without refund.

I consent to BC Fitness Cumbria Limited administering or arranging emergency medical treatment on my behalf in the event that I am unable to consent to such treatment myself.

I have read and understood the liability waiver above. I accept the risks of participation and release BC Fitness Cumbria Limited from liability as described. * I agree to comply with all event rules and movement standards set by BC Fitness HQ on race day. I understand that failure to comply or aggressive conduct may result in disqualification. * I confirm that I am in good physical health and have answered all PAR-Q questions honestly. If I answered YES to any PAR-Q question, I have obtained or will obtain medical clearance before race day. *

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PHOTOGRAPHY & DATA CONSENT

I consent to BC Fitness HQ using photographs and video footage of me taken during the event for social media, marketing, and promotional purposes. Optional. You can participate without giving this consent. I confirm I have read and understood how my personal data will be used. My data will be used for event administration and participant safety, retained for 2 years, and not shared with third parties without my consent. * You have the right to access, correct, or request deletion of your data at any time.

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DECLARATION AND DIGITAL SIGNATURE

By typing your full name below, you confirm that all information you have provided is accurate and complete, that you are 16 years of age or older, and that you agree to all terms in this document. Your typed name constitutes a legally binding digital signature.

TYPE YOUR FULL LEGAL NAME AS YOUR DIGITAL SIGNATURE *

By typing your name above you are signing this document electronically and agreeing to all terms.

DATE *

PAR-Q & LIABILITY WAIVER