ACL Rehab Blueprint: From Start to Sport Course Form - September 12-13, 2026
Please read carefully - there is a maximum of 44 people for each course and every course so far has sold out.
Full Name
*
First Name
Last Name
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
*
Format: (000) 000-0000.
E-mail
*
example@example.com
Profession
Physical Therapist / Physio
Physical Therapy Assistant
Athletic Trainer
Student
Terms and conditions - Please read carefully
Description of Potential Risks: There will be lab components that involve exercises and movements. Participants are not required but encouraged to participate in the labs if they are physically able.
I understand that the reaction of the heart, lung, blood vessels as well as other systems to exercise cannot always be predicted with accuracy. I know there is a risk of certain abnormal changes occurring during the following exercise, which include abnormalities of blood pressure or heart attacks as well as other side effects. Use of weight lifting equipment, engaging in heavy body calisthenics and performing sport specific movements may lead to musculoskeletal strains, pain and injury if adequate warm-up, gradual progression, and safety procedures are not consistently followed. I understand that Wesley Wang DPT, Wesley Wang LLC, Healthy Baller LLC, shall not be liable for any damages arising from personal injuries sustained by the client (buyer) during and/or from the ACL Rehab Blueprint: From Start to Finish course. The client (buyer) is taking part in this personal training problem at his/her own risk. Client (buyer) assumes full responsibilities for any injuries or damages which may occur during and/or after training. I hereby fully and forever release and discharge, Wesley Wang DPT, Wesley Wang LLC, Healthy Baller LLC, its assigns and agents from all claims, demands, damages, rights of action, present and future therein. I understand and warrant, release and agree that I am in good physical condition and that I have no disability, impairment or ailment preventing me from engaging in active or passive exercise that will be detrimental to heart, safety, or comfort, or physical condition if I engage or participate (other than those items fully discussed on the health history form).
I hereby grant permission to Dr. Wesley Wang, DPT to take & use photographs and/or digital images of me for use in promotional advertisements. These materials might include printed or electronic publications, websites or other electronic communications. I further agree that my name and identity may be revealed in descriptive text or commentary in connection with the image(s). I authorize the use of these images without compensation to me.
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ACL Rehab Blueprint Course Registration Fee
$850.00
$
850.00
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