This form MUST be completed by all participants of the StrongDads Misogi.

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Event: 26km Log Carry Date: 27th-28th December Organiser: StrongDads CIC

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Please read this document carefully. It affects your legal rights. By signing this form, you acknowledge that you have read, understood, and agree to the terms and conditions outlined below.

Full Name *

Date of birth *

Address

Street Address

City

Postal Code

Phone *

Email *

Emergency Contact Name *

Emergency Contact Phone *

Health Declaration

You must be in good physical and mental health to participate in this arduous endurance event. Please answer the following questions honestly. This information will be kept confidential and used only to ensure your safety and the safety of others.

1. Have you been advised by a doctor or other medical professional not to participate in strenuous physical activity? *

If yes, please provide details in the comment box at the bottom.

2. Do you have any known heart conditions, including high blood pressure, or have you ever experienced chest pains during physical activity? *

If yes, please provide details in the comment box at the bottom.

3. Do you have any known respiratory conditions, such as asthma? *

If yes, please provide details in the comment box at the bottom.

4. Do you have any known back, joint, or other musculoskeletal problems that could be aggravated by carrying a heavy load over uneven terrain? *

If yes, please provide details in the comment box at the bottom.

5. Do you have diabetes or any other condition that may require management during the event? *

If yes, please provide details in the comment box at the bottom.

6. Are you currently taking any medication that could affect your performance or safety during the event? *

If yes, please provide details in the comment box at the bottom.

7. Do you have any allergies (e.g., to food, medication, insect stings)? *

If yes, please provide details in the comment box at the bottom.

8. Have you experienced any recent injuries or illnesses that could affect your ability to participate? *

If yes, please provide details in the comment box at the bottom.

Details for any "Yes" answers:

By checking this box, I consent to receive transactional messages related to my account, orders, or services I have requested. These messages may include appointment reminders, order confirmations, and account notifications among others. Message frequency may vary. Message & Data rates may apply.Reply HELP for help or STOP to opt-out.

By checking this box, I declare that to the best of my knowledge, I am medically fit to participate in this event and that the information provided above is true and accurate.

Assumption of Risk

I understand that participation in the StrongDads CIC 26km Log Carry is a hazardous activity that involves significant risks of physical injury, including but not limited to:

•Falls and trips on arduous and uneven terrain.

•Injuries from carrying a heavy and awkward log.

•Muscle strains, sprains, and other soft tissue injuries.

•Exhaustion, dehydration, and hypothermia due to the strenuous nature of the event and potential weather conditions.

•Contact with other participants, event staff, or members of the public.

•Risks associated with being in a remote outdoor environment.

I acknowledge that these risks cannot be completely eliminated, even with the best safety precautions. I voluntarily assume full and complete responsibility for any injury or accident that may occur during the event, while on the event premises, or while travelling to or from the event.

Release and Waiver of Liability

In consideration of being permitted to participate in this event, I, on behalf of myself, my heirs, executors, administrators, and next of kin, hereby waive, release, and discharge StrongDads CIC, its directors, officers, employees, volunteers, and agents from any and all liability, claims, demands, actions, or causes of action whatsoever arising out of or related to any loss, damage, or injury, including death, that may be sustained by me, or to any property belonging to me, whether caused by the negligence of the releasees or otherwise, while participating in the event, or while in, on or upon the premises where the event is being conducted.

This waiver does not extend to any liability that cannot be legally excluded under UK law, such as liability for death or personal injury caused by the negligence of StrongDads CIC.

Consent for Medical Treatment

I hereby consent to receive medical treatment which may be deemed advisable in the event of injury, accident, and/or illness during this event. I understand that I am responsible for any and all medical expenses incurred as a result of my participation.

Agreement to Follow Rules

I agree to abide by all rules and instructions given by the event organisers and staff. I understand that my participation may be terminated if I fail to do so.

Signature

By signing below, I confirm that I have read and understood this Health Declaration and Liability Waiver in its entirety and agree to be bound by its terms.

Participant Signature *

Date Agreed