Congratulations on Taking Action!

I should be in contact with you soon (within 48 hours). If you have any questions or need to get a hold of me sooner please call 561-317-3576.

You’re almost done! Before I contact you please fill out the forms below and submit them:

  • Physical Activity Readiness Questionnaire

    (A Questionnaire for People Aged 15 - 69)

    Regular physical activity is fun and healthy, and increasingly more people are starting to become more active every day. Being more active is very safe for most people. However, some people should check with their doctor before they start becoming much more physically active. If you are planning to become much more physically active than you are now, start by answering the seven questions in the boxes below. If you are between the ages of 15 and 69, the PAR-Q will tell you if you should check with your doctor before you start. If you are over 69 years of age, and you are not used to being very active, check with your doctor. Common sense is your best guide when you answer these questions. Please read the questions carefully and answer each one honestly.

  • If you answered YES to one or more questions... Talk with your doctor by phone or in person BEFORE you start becoming much more physically active or BEFORE you have a fitness appraisal. Tell your doctor about the PAR-Q and which questions in which you answered YES. You may be able to do any activity you want - as long as you start slowly and build up gradually. Or, you may need to restrict your activities to those which are safe for you. Talk with your doctor about the kinds of activities you wish to participate in and follow her/his advice. Find out which community programs are safe and helpful for you.
  • If you answered NO honestly to all PAR-Q questions, you can be reasonably sure that you can... 1. Start becoming much more physically active - begin slowly and build up gradually. This is the safest and easiest way to go. 2. Take part in a fitness appraisal - this is an excellent way to determine your basic fitness so that you can plan the best way for you to live actively. It is also highly recommended that you have your blood pressure evaluated. If your ready is over 144/94, talk with your doctor before you start becoming much more physically active.
  • "I have read, understood and completed this questionnaire. Any questions I had were answered to my full satisfaction."
  • (for participants under the age of majority)
  • MM slash DD slash YYYY
  • This field is for validation purposes and should be left unchanged.

Waiver & Release

  • I acknowledge that participation in this program is strenuous and potentially hazardous. I should not run and participate in such a program unless I am physically able and properly trained. I assume all risks associated with running in such a program including, but not limited to injuries, falls, weather conditions and the hazards of running on roads and trails without traffic control.  I certify that I am physically fit and have sufficiently trained for participation in this program and have not been advised otherwise by a qualified medical professional.   


    I hereby waive any and all claims or causes of action that I may now or in the future have against The Running Warrior (the “Program”), or any person assisting or associated with the Program in any manner whatsoever, where such claim or cause of action has arisen or may arise in any manner whatsoever out of my participation in the Program. I hereby release the Program and all such persons from any claims, causes of action, or liabilities that have arisen or may arise out of my participation in the Program.  By my signature below I acknowledge that I have read and understand this waiver and release.


    I acknowledge that any medical attention that I (my son or daughter) may require is the injured party’s responsibility and I waive and release the Program from any financial responsibility.

    In consideration of acceptance of my application, I grant permission to the foregoing for use of any photographs, videos, recordings, or written statements associated with the Program for legitimate purposes. I agree to abide by the decisions and recommendations of the coaches of this Program relative to my ability and safety.

  • This is an electronic signature and by typing your name you're acknowledging all that's outlined above.
  • Please enter a number from 1 to 100.
  • MM slash DD slash YYYY
  • Signature is required for athletes under 18 years of age
  • This field is for validation purposes and should be left unchanged.

Fit to Run

  • If you enjoy running for recreation, health or competition we would like to know more about your running journey and intentions so we can better serve you. Please take a few moments to complete this survey. We value your input!
  • (Novice, Intermediate, or Advanced)
  • This field is for validation purposes and should be left unchanged.