Participants with a history of heart problems and/or high blood pressure are at risk while participating on the Ropes and Challenge Course due to the emotional and physical demands involved. Whereas heart attacks and fatalities have occurred in situations where individuals with pre-existing heart/high blood pressure conditions have participated in Ropes and Challenge Course activities, Mt. Morris Camp and Conference Center cannot guarantee your physical safety should you choose to participate. Mt. Morris Camp and Conference Center asks that all participants answering YES to question #11 acquire a written approval from their physician prior to participation.
For General Information Regarding Pregnancy, please note the following:
The activities involve twisting, turning, lifting, supporting body weights, unexpected physical contact, potential falling from various heights, and waist harness usage. By participating in these activities while pregnant, you will put yourself and your unborn child at risk and in potentially dangerous situations. Should you decide to participate, Mt. Morris Camp and Conference Center cannot guarantee the safety of you or your unborn child. If you are pregnant and wish to participate, Mt. Morris Camp and Conference Center asks that you attain a physician’s written approval.
I have read the Mt. Morris Camp and Conference Center Health Forms (Forms 2 and 3) and fully understand them without question. The information I provided is accurate to the best of my knowledge.
Participant’s Signature __________________________________ Date ______________