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Spring 2023 "IFH": Inclusive Fitness & Health

VCU Fitness Logo- Wheelchair (1) (1).jpg

 

Inclusive Fitness & Health 

Jacob's Chance Fitness promotes overall wellness through sports, health, and fitness education and social interaction for individuals with intellectual and physical challenges. This fitness program run by the VCU Kinesiology and Health Sciences department is designed for youth and young adults ages 10-40 years old.

Registration ends 1/29

 

Spring 2023

DATES: Sundays, February 5th - April 23rd (no sessions on 3/5, 3/12, and 4/9)

TIMES:

3-4pm (ages 10-20)

4:05-5:05pm (ages 21-40)

LOCATION: SCOR outdoor field (1365 Overbrook Rd Richmond, VA 23220)

 

COVID-19 Policy (effective 9/1): Masks are strongly encouraged for participants, parents/caregivers, volunteers, and instructors at all events/programs with Jacob's Chance (if medically able to wear one), regardless of vaccination status. Thank you for doing your part to keep everyone safe!

                                                                   

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Jacob's Chance is able to process refunds up until a week prior to the start of the session, minus a 10% processing fee.
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Contact Information
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First Name
Last Name
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Address Line 1
Address Line 2
City
State/Province
ZIP/Postal Code
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Participant Information
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First Name
Last Name
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(mm/dd/yyyy)
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Is there anything we should know about the participant to ensure they have the most success possible? What encourages your participant? What are some successful deescalation techniques, if any?
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Data collection is used only for grant compliance and internal review purposes.
Data collection is used only for grant compliance and internal review purposes.
Participant 2 Information
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First Name
Last Name
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(mm/dd/yyyy)
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Is there anything we should know about the participant to ensure they have the most success possible? What encourages your participant? What are some successful deescalation techniques, if any?
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Data collection is used only for grant compliance and internal review purposes.
Data collection is used only for grant compliance and internal review purposes.
Health and Safety Waiver

In consideration of being allowed to participate in any way in the program, related events and activities, and use of equipment, I the undersigned, acknowledge, appreciate, and agree that:

  1. The risk of injury from the activities involved in this program is significant, including the potential for paralysis and death.
  2. I KNOWINGLY AND FREELY ASSUME ALL SUCH RISKS, both known and unknown, EVEN IF ARISING FROM THE NEGLIGENCE OF THE RELEASEES or others and assume full responsibility for my participation.
  3. I willingly agree to comply with terms and conditions for participation. If I observe any unusual significant hazard during my presence or participation, I will remove myself from participation and bring such to the attention of the nearest official immediately.
  4. I, for myself and on behalf of my heirs, assigns, personal representatives, and next of kin, HEREBY RELEASE, INDEMNIFY, AND HOLD HARMLESS the Host, it’s officers, officials, agents, and/or employees, other participants, sponsors, advertisers, and if applicable, owners and lessors of premises used to conduct the event (RELEASEES), from any and all claims, demands, losses, and liability arising out of or related to any INJURY, DISABILITY OR DEATH I may suffer, or loss or damage to a person or property, WHETHER ARISING FROM THE NEGLIGENCE OF THE RELEASEES OR OTHERWISE, to the fullest extent permitted by law.
  5.  COVID-19 ACKNOWLEDGMENT AND WAIVER:  The novel coronavirus, COVID-19, has been declared a worldwide pandemic by the World Health Organization. COVID-19 is reported to be extremely contagious. While Jacob’s Chance is taking reasonable steps and precautions to lessen the risk of transmission of COVID-19 or other communicable diseases, and while Jacob’s Chance is following CDC guidelines and applicable state and county health department guidelines and orders, it is not possible to prevent against the presence of these diseases.  THEREFORE, I RECOGNIZE AND UNDERSTAND THAT Jacob’s Chance is not responsible in any manner for any risks related to communicable diseases in connection with Participant’s participation in the activities. Specifically, I understand that COVID-19 is a highly contagious and dangerous disease and that contact with the virus that causes COVID-19 may result in loss, damage, expense or significant personal injury, sickness or death.  I am fully aware that participation in the Activities carries with it certain inherent risks related to the transmission of communicable diseases that cannot be eliminated regardless of the care taken to avoid such risks, including, but not limited to: (1) the risk of coming into close contact with individuals or objects that may be carrying a communicable disease; (2) the risk of transmitting or contracting a communicable disease, directly or indirectly, to or from other individuals; and (3) injuries and complications ranging in severity from minor to catastrophic, including death, resulting directly or indirectly from communicable diseases or the treatment thereof (“Inherent Risks”). Further, I understand that all of the Inherent Risks are not fully understood and that the exact methods of spread and contraction are unknown, and there is no known treatment, cure, or vaccine. I hereby voluntarily accept and assume all risk of loss, personal injury, sickness, death, damage, and expense for myself arising from such Inherent Risks.

Furthermore, I represent and warrant that I do not knowingly carry any communicable diseases that may be transmitted during participation in the activities.

Health Statement

I will notify Jacob’s Chance ownership or employees if I suffer from any medical or a health condition that may cause injury to myself, others, or may require emergency care during my participation.

1365 Overbrook Rd, Richmond, VA 23220

804-640-8109

info@jacobschance.org

Media Wavier
Jacob’s Chance has my permission to use my and/or my child’s photograph publically to promote the organization. I understand that the images may be used in print publications, online publications, presentations, websites, and social media. I also understand that no royalty, fee or other compensation shall become payable to me by reason of such use.
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First Name
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