Assumption of Risk, Release, Waiver of Liability and Annual Concussion Protocol

IMPORTANT NOTICE: This agreement applies to all participants in PR Blocks Inc. youth track and field programs, including minor athletes (under 18 years of age) and young adult athletes (18 years of age or older). For minor athletes, this agreement must be read and signed by the participant's parent or legal guardian. Adult athletes (18+) must sign this agreement for themselves. Please read this document carefully before signing.

Families with multiple participants - Please fill out one of these forms per athlete. Once you submit, you can immediately fill out an additional form.

Section 1: Participant Information:

Emergency Contact Information:

Optional Secondary Emergency Contact:

SECTION 2: HEALTH AND PHYSICAL READINESS

PR Blocks Inc shall operate under the impression that each participant engages in all training activities with full knowledge of their physical readiness and ability to participate. This includes coach-led, track and field-based, and high-intensity interval workouts provided by PR Blocks Inc. 

If the participant's health status changes at any time during their relationship with PR Blocks Inc — including any change in a Physical Activity Readiness (PAR-Q) response — a PR Blocks staff member must be notified before any further participation. PR Blocks Inc reserves the right to require written physician clearance prior to participation at any time. 

Please postpone participation if you feel unwell due to illness, including cold, fever, or communicable illness, out of respect for fellow athletes and staff. 

SECTION 3: CONCUSSION AND HEAD INJURY POLICY

In compliance with Florida law and in accordance with the health and safety of all athletes, PR Blocks Inc has adopted the following concussion policy: 

(a) Any participant suspected of sustaining a concussion or head injury during practice or competition will be immediately removed from activity. 

(b) A participant who has been removed from activity due to a suspected concussion may not return to participation until they have submitted written medical clearance from a licensed healthcare provider to a PR Blocks Inc coach or staff member and have successfully completed the mandatory Return-to-Play protocol. 

(c) The parent or guardian of each minor athlete acknowledges receipt of information explaining the nature and risk of concussion and head injury, as required under Florida law, and consents to this policy on an annual basis by signing this agreement. 

This protocol summary and the full protocol on the prblocks website serves as the mandatory operational policy for PR Blocks, Inc. By participating in or coaching with PR Blocks, Inc., all parties agree to abide by the requirements herein. Failure to adhere to this protocol, particularly the removal-from-play and physician-clearance mandates, may void insurance coverage and result in disciplinary action, up to and including removal from the team or training program. This shall serve as the mandatory annual notice and acceptance required by  Florida Statute § 943.0438

SECTION 4: ASSUMPTION OF RISK

Participation in track and field and any related athletic activities carries inherent risks of physical injury, including but not limited to: muscle strains, sprains, fractures, heat-related illness, cardiovascular events, and other bodily harm. By signing this agreement, the participant (or their parent/guardian, if a minor) voluntarily acknowledges and accepts these risks. 

The participant and/or parent/guardian further acknowledge that: (a) there is an inherent risk of injury in all physical activity; (b) certain negative physical conditions may occur during or following activity; (c) when participating in outdoor activities, participants are responsible for appropriate clothing, footwear, sun protection, and hydration; and (d) registration for activities is limited to individual participation only. 

SECTION 5: RELEASE, WAIVER OF LIABILITY, AND INDEMNIFICATION

To the fullest extent permitted by applicable law, the participant (and/or their parent or legal guardian, if the participant is a minor) hereby waives all claims, assumes all liability, and releases, holds harmless, indemnifies, and agrees to defend PR Blocks Inc, its affiliates, subsidiaries, successors, assigns, agents, representatives, coaches, and employees from any and all liability for injury, claim, cause of action, suit, demand, or damages — including personal injury, property damage, economic loss, consequential damages, and punitive damages — arising from or related to: 

(1) Failure to disclose pre-existing medical conditions, limitations, or sensitivities; (2) Presence on or near any PR Blocks Inc workout location or facility; 

(3) Participation in any PR Blocks Inc activity, whether in-person, outdoors, or online; (4) Use of any equipment at any PR Blocks Inc workout or event; and/or 

(5) Any negligence on the part of PR Blocks Inc or its employees or agents, to the extent permitted by law. 

This release is intended to be as broad and inclusive as permitted by Florida law. If any portion is held invalid, the remaining provisions shall continue in full legal force and effect. These provisions are binding upon the participant, their estate, heirs, family, administrators, personal representatives, and assigns.

SECTION 6: ADDITIONAL PROVISIONS FOR MINOR ATHLETES

If the participant is under 18 years of age at the time of signing, the parent or legal guardian signing this agreement on their behalf represents that they have the legal authority to do so, have read and understood this agreement in full, and consent to their child's participation in PR Blocks Inc programs on the terms stated herein. 

The parent or guardian further consents to emergency medical treatment for the minor participant if PR Blocks Inc staff are unable to reach the parent or guardian in a timely manner and medical care is required. This does not obligate PR Blocks Inc to provide or arrange medical care. 

The parent or guardian acknowledges that this club team includes participants of varying ages, including young adult athletes who are 18 years of age or older, and consents to their child's participation in a mixed-age program environment. 

SECTION 7: ADDITIONAL PROVISIONS FOR ADULT ATHLETES (18+) 

Adult participants (18 years of age or older) signing this agreement do so for themselves and acknowledge that they are legally competent to enter into this binding agreement. Adult athletes further acknowledge that this program includes minor athletes, and agree to conduct themselves at all times in a manner consistent with a safe, respectful, and appropriate environment for minors. 

Adult athletes acknowledge that they are mandatory reporters of child abuse or neglect under applicable Florida and federal law. If an adult athlete witnesses or has reasonable suspicion of abuse, neglect, or exploitation of a minor participant, they are required by law to report it immediately to law enforcement and/or the Florida Department of Children and Families (DCF Hotline: 1-800-962-2873). 

SECTION 8: USE OF IMAGE, LIKENESS, AND VOICE

PR Blocks Inc may photograph, record on audio or video, or otherwise capture participant activity during training sessions, events, and competitions. By signing this agreement, the participant (and/or their parent/guardian, if a minor) consents to the use of such recordings for promotional, educational, or commercial purposes in any media, now or hereafter devised, without additional compensation. The participant waives the right to inspect or approve any finished content containing their likeness or voice. 

For minor athletes, parental/guardian consent is required for any media use and is granted by signature on this agreement. PR Blocks Inc agrees not to publicly identify minor athletes by full name in any digital or social media context without separate written consent. 

SECTION 9: PHONE AND TEXT MESSAGE AUTHORIZATION

Text messages are optional. PR Blocks Inc. sends text messages only to adults who tick one or both of the separate, unchecked text-message boxes on this form (Reminders and updates; Offers) or opt in another way described in our Terms and Conditions. Signing this waiver does not by itself consent to text messages, and we do not text participants under 18.

SECTION 10: USE OF PARTICIPANT INFORMATION 

PR Blocks Inc may use de-identified information gathered through participation for research, program development, and statistical purposes, provided such information does not personally identify the participant. The participant and/or parent/guardian agrees to hold harmless PR Blocks Inc from any claims related to libel, invasion of privacy, or violation of publicity rights arising from the use of de-identified information. 

SECTION 11: SIGNATURES AND ACKNOWLEDGMENT 

I/We have read, understand, and agree to comply fully with all terms and conditions stated in this agreement. I/We acknowledge receipt of this document.