Senior Archery Wellness Registration

Senior Archery Wellness Registration

Register for The Luck Group Senior Archery Wellness Program
Full Name*

First NameLast Name
Date of Birth (Must be 55 years or older)*

MonthDayYear
Date
Email Address*
example@example.com
Phone Number*
Please enter a valid phone number.Format: (000) 000-0000.
Home Address

Street Address

Street Address Line 2
CityState / ProvincePostal / Zip Code
Emergency Contact Name*

First NameLast Name
Emergency Contact Phone Number*
Please enter a valid phone number.Format: (000) 000-0000.
Do you have any health conditions or physical limitations we should be aware of?
If yes, what conditions or limitations should we be aware of?
Have you ever used Archery Equipment?
How did you hear about The Luck Group Senior Archery Wellness Program?
Assumption of Risk & Release of Liability
I understand that participation in the Senior Archery Wellness Program offered by The Luck Group involves physical activity that may include, but is not limited to:

Target archery using adaptive equipment
Light physical movement and coordination exercises
Outdoor or indoor recreation activities
Instructional demonstrations involving archery equipment

I acknowledge that participation in these activities carries inherent risks including, but not limited to:

Minor injuries
Muscle strain
Slips or falls
Equipment-related incidents

By signing this agreement, I acknowledge that I voluntarily choose to participate in the program and assume all risks associated with these activities.

Medical Acknowledgement
I certify that:

I am physically able to participate in light recreational activities.
I will inform program instructors of any physical limitations, injuries, or medical conditions that may affect my participation.
I understand that The Luck Group staff are not medical professionals and that participation is voluntary.
Participants are encouraged to consult with their physician prior to engaging in new physical activities.

Release of Liability
In consideration of being allowed to participate in the Senior Archery Wellness Program, I hereby release, waive, and discharge:

The Luck Group, its directors, officers, employees, volunteers, instructors, partners, host facilities, and sponsors from any and all liability, claims, demands, actions, or causes of action arising from any injury, loss, or damage that may occur during participation in the program.

This release applies whether the activity occurs indoors or outdoors and includes travel to and from the activity site.

Safety Agreement
Participants agree to:

Follow all safety instructions provided by instructors
Use archery equipment only as instructed
Maintain safe distances from other participants
Notify staff immediately of any discomfort or injury
Failure to follow safety rules may result in removal from the activity.
Yes, I give permission to photos or video of me participating in the program to be used for educational or promotional purposes.No, I do not give permission for photos or videos to be used.
Participant Signature I have read and fully understand this waiver and voluntarily agree to its terms.

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