Consent and Waiver
I, the undersigned participant or legal guardian of the participant (if under 18 years of age), hereby consent to participate in the selected course(s) on this form.
I understand and acknowledge the following:
1. I have been informed of the nature and purpose of the 4 Elements 4 Life AHA BLS, Heartsaver® First Aid, CPR, AED, and/or Bloodborne Pathogens course(s) and have had an opportunity to ask any questions.
2. I am voluntarily participating in the course and understand that it involves training in cardiopulmonary resuscitation (CPR), automated external defibrillator (AED) use, First Aid, and basic life-saving techniques.
3. I am aware that the course may involve hands-on practice, demonstrations, and assessment of life-saving skills.
4. I understand that successful completion of the course may involve passing a written and practical skills test.
5. I consent to any necessary first aid or emergency medical treatment that may be administered by qualified personnel in the event of injury, illness, or accident during the course.
6. I release the American Heart Association, 4 Elements Health & Wellness LLC, and 4 Elements Direct Primary Care LLC and its independednt contractor Moe Karp LLC, from any liability related to any injuries or accidents that may occur during the course.
7. I grant permission for the use of photographs, video, or other media taken during the course for educational or promotional purposes by 4 Elements Health & Wellness LLC, and 4 Elements Direct Primary Care LLC and its independednt contractor Moe Karp LLC. I understand this consent may be revoked in writing at any time.
8. I understand that certification in Heartsaver courses is valid for a specific period and may require renewal or recertification.
9. I understand this is an education and training course, and that there is no guarantee of my correct performance of such skills in an emergency situation, and that the outcome in such situations is fully my responsibility.
I have read and understand the information provided in this consent form, and I agree to abide by the rules and regulations set forth by the American Heart Association, 4 Elements Health & Wellness LLC and its indepenedednt contractor, Moe Karp LLC.