Kaiser Permanente Corporate Run/Walk Boot Camp Information

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Horace Fowler
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Kaiser Permanente Corporate Run/Walk Boot Camp Information Lead by: Celebrity Fitness Trainer, Tammie Leady 2017 Boot Camp Dates: July 22, 29, August 5, 12, 19, 26 (in the event of rain, boot camp

1 Kaiser Permanente Corporate Run/Walk Boot Camp Information Lead by: Celebrity Fitness Trainer, Tammie Leady 2017 Boot Camp Dates: July 22, 29, August 5, 12, 19, 26 (in the event of rain, boot camp will be cancelled) Start Time: Promptly at 7 a.m. Location: Piedmont Park (entrance to Sage Parking Deck at 1320 Monroe Drive) Eligibility: Participants must be registered for the KP Corporate Run/Walk Participants must bring their KP Run/Walk event confirmation, photo ID and the completed waiver to their first boot camp session in order to be able to participate. Location of the boot camp: Active oval (Soccer Field) in the middle of Piedmont Park. Parking: Sage Parking Deck 1320 Monroe Drive, NE Atlanta, GA (Don t forget to bring money for parking see driving directions) Daily Parking Rates Drop-off period (0-15 minutes) no charge minutes $ 0.75 Each additional 30 minutes $ 1.00 Photos/Video: We are photographing and videotaping portions of the event so wear your smile. (We have attached the photo release form. Please complete and bring the completed form with you.) Attire: Please wear comfortable clothing and shoes. It is recommended that you wear a visor and apply sunscreen. Please bring your own personal water bottle and a towel. Check-in: All participants must check in when they arrive and turn in your waiver form before the event begins. If you are not listed you will not be able to participate in the fitness activity.

2 More Information: Please do not bring purses or bags -- we will not have a secure place to hold them and cannot be responsible for them. All participants must be registered. Please do not bring extra people, children or pets. The July 22 boot camp will establish the fitness level of participants by using a one mile walk test. Afterwards, participants will be placed in their level of intensity and arrangement of exercises. All levels are welcome! Participant s fitness levels will identified by colors: Yellow Beginners Orange - Intermediate Green - Experienced The boot camp will be set-up into fitness stations.

3 Driving Directions to Piedmont Park SAGE Parking Facility Coming from the north of Midtown on I-75 southbound: Take EXIT 250 (10th St., 14th St. & 16th St.) 0.4mi Stay left on ramp toward 14th/10th St. 0.6mi Turn LEFT onto 10th St -travel east until 10th ends at Monroe Dr. 1.3mi Coming from North of Midtown on Interstate 85 southbound: Take EXIT 84 (10th St. & 14th St.) Turn LEFT at 10th - travel east until 10th dead ends at Monroe Dr. 1.3mi Coming from North of Midtown on Hwy. 400: Take EXIT for I-85 Southbound where Hwy 400 comes to an end 2.2mi Take EXIT 84 (10th St. & 14th St.) Turn LEFT at 10th St. -travel east until 10th dead ends at Monroe Dr. 1.3mi Coming from South of Midtown on I-75/85 northbound: Take EXIT 250 (10th &14th St.) 0.3mi Turn RIGHT at 10th- travel east until 10th dead ends at Monroe Dr. 1.3mi Turn LEFT at WORCHESTER to SAGE parking facility that serves Piedmont Park

4 Kaiser Permanente Corporate Run/Walk Boot Camp WAIVER AND RELEASE OF LIABILITY AND ASSUMPTION OF RISK AGREEMENT THIS DOCUMENT WILL AFFECT YOUR LEGAL RIGHTS PLEASE READ CAREFULLY BEFORE SIGNING ADVISORY: PARTICIPANTS ARE ADVISED TO CONSULT THEIR PHYSICIANS BEFORE STARTING AN EXERCISE PROGRAM. I, _, have voluntarily enrolled in a fitness program involving vigorous physical activity ( the Activity ), which is sponsored by Kaiser Foundation Health Plan of Georgia, Inc. (also referred to as Kaiser Permanente ). In consideration for being allowed to participate in any way in the Activity, I acknowledge, appreciate, and agree that: 1. Fitness programs are inherently hazardous and may result in accident, loss, damage, serious personal injury or death. With full knowledge of these risks, I KNOWINGLY AND FREELY ASSUME ALL SUCH RISKS, both known and unknown, EVEN IF ARISING FROM THE NEGLIGENCE OF KAISER PERMANENTE, and assume full responsibility for my participation; 2. I willingly agree to comply with the stated and customary terms and conditions for participation. If, however, I feel the Activity to be unsafe or if I observe any unusual significant hazard during my presence or participation, I will remove myself from participation and bring such to the attention of the nearest instructor immediately; and, 3. I, for myself and on behalf of my heirs, assigns, personal representatives and next of kin, HEREBY WAIVE ANY RIGHTS I MAY HAVE TO SUE KAISER FOUNDATION HEALTH PLAN OF GEORGIA, INC., THE SOUTHEAST PERMANENTE MEDICAL GROUP, AND Their Respective AFFILIATES for ANY AND ALL PERSONAL INJURY OR PROPERTY DAMAGE SUFFERED BY me ARISING OUT OF MY ATTENDANCE OR PARTICIPATIION IN THE ACTIVITY. 4. AND HEREBY RELEASE AND HOLD HARMLESS KAISER FOUNDATION HEALTH PLAN OF GEORGIA, INC., THE SOUTHEAST PERMANENTE MEDICAL GROUP, Their Respective AFFILIATES, officers, officials, agents and/or employees, other participants, sponsoring agencies, sponsors, volunteers, advertisers, independent instructors, anyone administering emergency medical assistance, and, if applicable, owners and lessors of premises used to conduct the Activity ( Releases ), WITH RESPECT TO ANY AND ALL INJURY, accident, loss or damage to myself or my property arising out of my attending or participating in the Activity, WHETHER ARISING FROM THE NEGLIGENCE OF THE RELEASEES OR OTHERWISE.

5 5. I hereby consent to the photographing, recording or reproduction in any other manner (including the use of videotapes and audiotapes) of my likeness, voice and/or activities and further authorize KAISER FOUNDATION HEALTH PLAN OF GEORGIA, INC. to make unlimited use of such reproductions, including but not limited to, broadcasting to the public of the reproductions over radio, television stations, and social media. I understand that I will not receive any monetary compensation, now or in the future, for participating and waive any right I may have to such compensation. I hereby release and hold harmless KAISER FOUNDATION HEALTH PLAN OF GEORGIA, INC. from any claims that may result from the use of such reproductions. 6. I affirm that I am in good physical condition and do not suffer from any disability that would prevent or limit my participation in the Activity and that I have been advised to consult with a physician prior to engaging in the activity. I HEREBY AFFIRM THAT I HAVE READ THIS WAIVER AND 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 ANY INDUCEMENTS. Participant s Signature & Date Printed Name Address & Telephone Number Emergency Contact Name & Telephone Number Every participant must read and understand this Waiver and Release of Liability and Assumption of Risk Agreement prior to participating in Kaiser Permanente physical activity programs. Rev. 04/17

CITY KIDS DAY CAMP REGISTRATION FORM

RETURN CAMP ENTRY FORM WITH PAYMENT TO: M.C. PARKS 100 E. MICHIGAN BLVD. SUITE 2 MICHIGAN CITY, IN 46360 (219) 873-1506 www.michigancityparks.com CITY KIDS DAY CAMP REGISTRATION FORM 1. HOUSEHOLD INFORMATION