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This exercise contract outlines the terms and conditions for using the Matt Dishman Community Center through passes issued by the NARA Diabetes Treatment & Prevention Program in Portland, OR. By signing, you agree to exercise safely and acknowledge your personal limitations.
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ExerciseContract NativeAmerican RehabilitationAssociationof the Northwest, Inc. Community center exercise contract/waiver Portland NARA of the Northwest DiabetesTreatment&PreventionTeam Matt Dishman Community Center 77NE Knott Portland,OR 97212 The followingisan Exercise Contractfor myuse of the MattDishmanCommunity Center (MDCC)throughpassesissuedfromthe NARADiabetesTreatment& PreventionProgram. Iunderstandthatone“Exercise Pass” willbe issuedtome to usethe pooland/or the fitnessroomat MDCC andthatthe passcannotbe replaced if lostor stolen. Iagree thatIwillbethe onlypersontouse thispassandtosignin atMDCC eachtime Iusethe facility. I agreetoexercisesafelyandwithinmypersonallimitations. IdeemNARAnotliable for anyinjuryor other accidentthat mayoccur overthe courseof my exercise program. IunderstandthatIshouldnotbeginanexercise programunless I ammedicallyable andhave consultedwithmyphysicianeitherinpersonoron thetelephone. I understandthatfundingforthisexerciseprogramat MattDishmanCommunity Center (MDCC)isbased onthe availabilityof grantfunds. TheNARADiabetes Treatment&PreventionProgramreservesthe righttodiscontinue fundingforthis programat anytime. MysignaturebelowindicatesthatIhave readthisExercise Contractthoroughly andagree tocomplywiththese rulesandregulations. PrintName Signature Date