Individual Non-competitive Mini-APFT

* First Name
 
* Last Name
 
* Address
 
* City
 
* State
 
* Zip Code
 
* Phone (include area code)
 
* Email
 
* Age on September 8, 2016
 
* Emergency Contact Name
 
* Emergency Contact Phone
 
* If registering prior to or on 8/28/16, please select a t-shirt size (adult sizes only)
 
Please note: Participants registering after 8/15/16 will select a T-shirt size on event day, subject to availability.
* Have you participated in a previous Community Fit Fair?
 
* How did you hear about the Community Fit Fair?
 
The Non-Competitive Mini-Army Physical Fitness Test includes 1 minute of push-ups, 1 minute of sit-ups, and a 1 mile run or walk.
If you want to participate in the same heat as another person(s), please list the name(s) here and we will try to accommodate your request.
* This event will be conducted in heats. Please indicate your top 2 choices for heat start times.
 
You will receive an email before the event with your heat start time. Please arrive at least 15 minutes prior to your start time and check in at the registration tent. From there you will meet your military squad leader. The mini-APFT will take approximately 30 minutes to complete and is not a scored event.

WAIVER AGREEMENT

In consideration of being allowed to participate in any way in the event, related events and activities, and use of equipment, I the undersigned, acknowledge, appreciate and agree that: 1.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.
2.I, for myself, and on behalf of my heirs, assigns, personal representatives and next of kin, HEREBY RELEASE, INDEMNIFY, AND HOLD HARMLESS the North Dakota National Guard, Bismarck State College, its officers, officials, agents and/or employees, other participants, partners, 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 of damage to person or property, WHETHER ARISING FROM THE NEGLIGENCE OF THE RELEASEES OR OTHERWISE, to the fullest extent permitted by law.

Media Statement

By signing below, I hereby grant and convey to the North Dakota National Guard and Bismarck State College, and if applicable, other sponsors and partners, all right, title and interest in and to record my name, image, voice or statements including any and all photographic images and video or audio recordings made by the North Dakota National Guard and Bismarck State College, and if applicable, other sponsors and partners.

I HAVE READ THIS RELEASE OF LIABILITY AND ASSUMPTION OF RISK AGREEMENT, FULLY UNDERSTAND ITS TERMS, UNDERSTAND THAT I HAVE GIVEN UP SUBSTANTIAL RIGHTS BY SIGNING IT, AND SIGN IT FREELY AND VOLUNTARILY WITHOUT AND INDUCEMENT.

FOR PARENTS/GUARDIANS OF PARTICIPANT OF MINOR AGE (UNDER AGE 18 AT TIME OF REGISTRATION)


This is to certify that I, as parent/guardian with legal responsibility for this participant, do consent and agree to his/her release as provided above of all the Releasees, and, for myself, my heirs, assigns, and next of kin, I release and agree to indemnify and hold harmless the Releasees from any and all liability incidents to my minor child's involvement or participation in these programs as provided above, EVEN IF ARISING FROM THE NEGLIGENCE OF THE RELEASEES, to the fullest extent permitted by law.

 
First and Last Name of minor participant (if applicable):
* Please Read:
 
For questions, please contact NDARNG

Erin DeMoe or Cathy Palczewski
North Dakota Army National Guard Substance Abuse Program
701-333-3266 or 701-333-3265
erin.n.demoe.ctr@mail.mil or cathy.s.palczewski.ctr@mail.mil
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