Register Welcome to RAD Nation. Before we get the party started, I need to know a few things. 1 Personal Information2 Health Information & Physical Readiness Questionnaire3 Legal Documents Name* Prefix First Last Suffix Date of Birth*Month123456789101112Day12345678910111213141516171819202122232425262728293031Year202420232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920Email* Enter Email Confirm Email Phone* Please answer all questions to the best of your ability. If you answer yes to any question please explain in detail in the space provided below.1. Has your doctor ever said that you have a heart condition and that you should only do physical activity recommended by a doctor?*YesNoQuestion 1 Explanation2. Do you feel pain in your chest when you do physical activity?*YesNoQuestion 2 Explanation3. In the past month have you had a pain in your chest when you were not doing physical activity?*YesNoQuestion 3 Explanation4. Do you lose your balance because of dizziness or do you ever lose consciousness?*YesNoQuestion 4 Explanation5. Do you have a bone or joint problem that could be made worse by a change in your physical activity?*YesNoQuestion 5 Explanation6. Is your doctor currently prescribing drugs (water pills, for example) for your blood pressure or heart condition?*YesNoQuestion 6 Explanation7. Do you know of any reason why you should not do physical activity?*YesNoQuestion 7 Explanation8. On a scale of 1-10 I rate my current physical level as a?*123456789109. My main goal is:*Additional Information/Comments: RAD Experience, LLC Informed Consent-Liability Waiver-Media Release I, ________________________________________, hereby agree to the following: 1. That I am participating in RAD Experience, LLC. (Founder, Owner: Robbie Ann Darby), during which I will receive information and instruction about health and fitness. I recognize that fitness programs require physical exertion which may be strenuous and may cause physical injury, and I am fully aware of the risks and hazards involved. 2. I understand that it is my responsibility to consult with a physician prior to and regarding my participation in RAD Experience, LLC. I represent and warrant that I am physically fit and I have no medical condition which would prevent my full participation in this program. 3. In consideration of being permitted to participate in RAD Experience, LLC., I agree to assume full responsibility for any risks, injuries, or damages, known or unknown, which I might incur as a result of participating in the program, including any and all injuries or damages that may result from any act or omission, negligent or otherwise, of RAD Experience, LLC. (Founder, Owner: Robbie Ann Darby). 4. IN FURTHER CONSIDERATION OF BEING PERMITTED TO PARTICIPATE IN RAD EXPERIENCE, LLC., I KNOWINGLY, VOLUNTARILY, AND EXPRESSLY WAIVE ANY AND ALL CLAIMS I MAY HAVE AGAINST RAD EXPERIENCE, LLC. (FOUNDER, OWNER: ROBBIE ANN DARBY) FOR INJURY OR DAMAGES THAT I MAY SUSTAIN AS A RESULT OF PARTICIPATING IN THE PROGRAM, INCLUDING ANY AND ALL INJURIES OR DAMAGES THAT MAY RESULT FROM ANY ACT OR OMISSION, NEGLIGENT OR OTHERWISE, BY RAD EXPERIENCE, LLC. (FOUNDER, OWNER: ROBBIE ANN DARBY). 5. I agree to be filmed for promotional and advertising purposes at the discretion of RAD Experience, LLC 6. I, my heirs, or legal representatives forever release, waive, discharge, and covenant not to sue RAD Experience, LLC. (Founder, Owner: Robbie Ann Darby) for any injury or death caused by their negligence or other acts. I HAVE READ THE ABOVE INFORMED CONSENT & LIABILITY WAIVER, AND FULLY UNDERSTAND ITS CONTENTS. I HEREBY AFFIRM THAT I’M OVER 18 AND I VOLUNTARILY AGREE TO THE TERMS AND CONDITIONS STATED ABOVE.Confirmation of Waiver* I have read and understand I understand that I must notify my trainer 24 hours in advance of any cancellations in regards to scheduled sessions. If I do not appear for a scheduled appointment or fail to give 24 hours notice, *I will be charged for the full session. *This does not apply to boot camps RAD Live! or any other group based events as these programs are non refundable despite the participant's attendance. I understand that all sessions, programs and packages are non refundable. *Purchased sessions expire after 120% of the predetermined scheduled time agreed between you and Robbie Ann Darby of RAD Experience, LLC. has surpassed. If you have questions on what this “predetermined schedule” is then please inquire before signing this agreement. *This does not apply to boot camps, RAD Live! or any other group based events as these programs expire once the preset event date has been reached. Confirmation of Cancellation Policy & Refund/Expiration Policy* I have read and understand NameThis field is for validation purposes and should be left unchanged.
