Sports Academy Health _ Fitness Challenge by sofiaie


									                              Sports Academy Ultimate Loser 6
                                            Presented by: Sports Academy
                                     You could win up to $10,000 in cash and prizes!

                                              Please Read Carefully
                                     Cost: $349 SARC Member $499 Non Member

      1.       Basic Registration Information:
      Last Name: _____________________ First Name: ____________________ D.O.B: _____/_____/_____
      Address: _________________________________ City: ________________ State: ______ Zip: _______
      Day Phone: _________________ Evening Phone: ________________ Occupation: ________________
      Email Address: _______________________________________________ *Required!!!!!
                   (If you don’t have an email address – you can create a free one at
      2.        Physical Activity Readiness Questionnaire (PAR-Q)                                                            please circle one.

      1.     Has a doctor ever said you have a heart condition and recommended only medically supervised activity?             Yes     No
      2.     Do you have chest pain brought on by physical activity?                                                           Yes     No
      3.     Do you tend to lose consciousness or fall over as a result of dizziness?                                          Yes     No
      4.     Has a doctor ever recommended medication for your blood pressure or a heart condition?                             Yes     No
      5.     Do you have a bone or joint problem that could be aggravated be the proposed physical activity?                    Yes    No
      6.     Are you aware, through your own experience or been warned by a doctor, or any other physician,                     Yes     No
             against your exercising without medical supervision?
      7.     Are you over the age of 65 and not accustomed to vigorous exercise?                                                Yes     No
             If you answered YES to one or more of the above questions, please answer the following questions:
      8.     Have you consulted with your physician regarding increasing your physical activity and/or performing a             Yes     No
             fitness assessment?
      9.     If you answered NO to question 8, will you consult your physician prior to increasing your physical activity       Yes     No
             and/or performing a fitness assessment?

3.          Pre-Exercise Questionnaire
1.         Current Resting Heart Rate: ______ bpm Current Cholesterol Level: ______ Current Blood Pressure: ______/______
2.         What is your main reason for exercising? Change Appearance Enhance Sports Performance Improve Health and Daily Activity
           Why?                                                               Why Now?
3.         Do you have a time frame in mind for accomplishing your health and fitness goals?            If so, what is it?
4.         Does your job require any of the following?
            1. Prolonged sitting or driving 2. Moderate movement 3. Heavy lifting 4. Repetitious, lifting or twisting 5. Night shift
5.         Are you currently participating in an exercise program?                                                            Yes      No
6.         Are you currently participating in a structured resistance-training program?                                       Yes      No
            If so, how long consistently? < 3 months     3 months to 1 year    > 1 year
7.         Are you currently participating in a structured cardio respiratory program?                                         Yes     No
            If so, how long consistently? < 3 months     3 months to 1 year    > 1 year
8.         How many days a week is it realistic for you to be working out at the gym?                       1 2 3 4 5 x per week
9.         How many times per day do you normally eat?                                                         1 2 3 4 5 x per day
     a.      Do you know how many calories you should be eating to reach your goal?                                              Yes        No
             If yes, how many and why?
     b.     Are you currently taking a multivitamin or any other type of food supplement?                                                    Yes   No
             If yes, what are you taking and why?

                    Participants Who Have Not Participated In Previous Ultimate Loser’s
                               Must Visit Their Physician Before Participation
                              Sports Academy Ultimate Loser 6
                                             Presented by: Sports Academy
                                      You could win up to $10,000 in cash and prizes!

                                               Please Read Carefully
                                                           Terms and Conditions
1.   Sports Academy Ultimate Loser 6:
Registration deadline is Wednesday October 7th at 3:00 pm or when Teams have filled up whichever comes first. Your registration will be
accepted and complete only when you have turned in your form, paid your entry fee, and signed up for a training time. Incomplete, non-
payment, or not signing up for training time in any combination means you are not registered. Saturday October 10th all participants will meet
at a USU Computer Lab (yet to be determined) for program/Bodybugg set up and schedule questions/answers. To participate in this challenge
YOU MUST attend the October 10th set up session. Due to time restraints and demand we will not set up anyone individually for this
challenge. Your first challenge day will be October 12th at your workout time you signed up for.
2.   How To Become Qualified:
Participants may pick up registration form and assessment form at Sports Academy & Racquet Club or online at Participants
must complete form, including visiting their physician (if you cannot see your physician, you can turn in a note/waiver of clearance after
competition starts), and return to Sports Academy & Racquet Club no later than Wednesday October 7th at 3:00 pm. Participants or legal guardian
must sign all forms. When turning in your registration form you must pay entry fee and sign up for your training time. Once a time slot has 10
participants that time slot is full. Which means you will need to sign up for another time or wait until another competition. Sign-ups are on a
first come basis. You are not signed up until your entry fee is paid, and registration form is turned in. Once you have paid your fees no refunds
will be given unless that training time is cancelled and you are not able to switch to another training time.
3.   Participants Will Receive:
             a.   Each participant will receive access to the Sports Academy & Racquet Club during for the period of the Ultimate Loser 6 to be no longer
                  than ten (10) weeks if not already a member.
             b.   Each participant will be in a team training group. Groups will have designated training times for the duration of the challenge led by a
                  trainer/instructor. (Value $750.00)
                         i.   All workouts will be at the Sports Academy, or will start and end at the Sports Academy and will last no longer than 60
             c.   Each participant will receive a bodybugg to use for the ten (10) week challenge along with web activation. (Value $225.00) At the
                  conclusion of the challenge the bodybugg may be turned in or purchased for $89.00.
4.   Cost:
             a.   The Sports Academy Ultimate Loser 6 registration fee is:
                         i.   Sports Academy Members: $349.00
                        ii.   Non – Sports Academy Members: $499.00
5.   Participants Agree To The Following:
             a.   Participant must follow all exercise and fitness guidelines set forth by trainer:
                         i.   Food Intake and Meal Planning. Female participants must maintain a minimum caloric intake of 1200 and males 1400
                              calories. You must keep your caloric intake up to date on your Bodybugg program. Your Bodybugg program will tell us
                              your caloric intake based on your weight and measurements. Any participant falling below calorie minimums will be
                              disqualified from winning any prizes.
                        ii.   Exercise programs (daily and weekly).
                       iii.   Only using Dot Fit Multivitamins and recommended nutritional support products. No other supplementation will be
                              accepted or allowed during challenge. Any contestant/individual found to be using unapproved supplement/nutritional
                              support products will be disqualified from winning any prizes.
                        iv.   Participant agrees to submit to blood/urine analysis at the discretion of Sports Academy personnel.

                    Participants Who Have Not Participated In Previous Ultimate Loser’s
                               Must Visit Their Physician Before Participation
                             Sports Academy Ultimate Loser 6
                                              Presented by: Sports Academy
                                       You could win up to $10,000 in cash and prizes!

                                             Please Read Carefully
           b.    Participants will not participate in unhealthy weight loss programs. You must adhere to your trainer’s minimum calorie intake level.
                 Your Bodybugg food logs will aid in tracking. Any deviations from rules and minimum calorie levels will result in disqualification from
                 contest. This includes not entering your calorie consumption.
           c.    Weigh-in attire: Men must weigh-in with swimming shorts; Women must weigh-in with swimming suit. Biking shorts and
                 sports bras will also be acceptable. All weigh-in attire must be tight/form fitting. Original pictures and 10 week pictures will be
                 taken in street clothes.
           d.    Participant must attend weekly weigh-ins, which are Fridays and must be in weigh-in attire for last weigh-in. Participants must attend
                 initial and final weigh-in. Participants missing more than (2) two weigh-ins will be eliminated from winning any prize(s).

6.   Sports Academy & Racquet Club will document all results on a daily and weekly basis, starting with beginning measurements and statistics.
     Results and findings will be compiled for analysis, findings to be used for marketing and will be posted on the Sports Academy Ultimate Loser
     website along with your picture in street clothes. All photos and information gathered will/can be used for promotional and marketing purposes.

7.   The Sports Academy Ultimate Loser is also a competition. SARC is promoting healthy weight loss and a healthy life style, but included in this you
     have the chance to win cash and other prizes. This competition has team challenges, but overall is an individual competition that will be based off
     of over-all weight loss percent.
           a.    Example: 1-(ending weight / starting weight) = weight loss %            1-(195/230)=.16 or 16% overall weight loss

8.   There will be 4 eliminations. Oct 26th, Nov 9th, Nov 23rd, Dec 7th. One person per group will be eliminated. You will only be eliminated from
     winning any Grand Prize(s). You will still be able to participate in all workout sessions and seminars. Eliminations will be based on participation
     which will be structured on a point system. The participant with the least amount of points will be eliminated. Each participant will have 5 excused
     absences. Once the role is turned in everything is final. In the event that a participant misses more than two (2) weigh-ins, that person will be
     eliminated at the next elimination. If multiple participants have the least number of participation points the tiebreak will be weight loss
     percent from that elimination period (time).
                                  A.               Weekly Points: these points will possibly save you from elimination. Points will be awarded based on
                                                   participation. For each group workout, seminar, or challenge you attend you will receive a point.
                                                   Points will reset at the beginning of each elimination period. Each elimination period the individual(s)
                                                   with the lowest point total will be eliminated.

9.   Participants must attend a minimum of 50 minutes of each group workout to get participation credit. If you’re more than 10 minutes late or leave
     more than 10 minutes early you will not get credit. This is based on your trainers watch. No exceptions/excuses will be accepted. If you’re late,
     you’re late, so just enjoy your workout!
                                  A.               Saturday Seminars and Competitions – These are required and will count towards your participation
                                                   points. In order to receive a prize you must be there to compete. Some competitions will be head to
                                                   head competitions between teams.
                                  B.               Participants eliminated because of missing weigh-ins are only eliminated from winning prizes.
                                                   Everyone can participate in Training for the whole 10 week challenge. You can still participate in all
                                                   group training and still win weekly group challenge prizes even if you have been eliminated.
                                  C.               If you are planning on being gone for an extended period of time (more than 7 days) please consider
                                                   waiting to do the next challenge.
10. Participants agree to follow all exercise and fitness guidelines set forth by personal trainer for the duration of Challenge not to be more than ten (10)
     weeks. Any participant not in compliance with the above terms will automatically be disqualified. No refunds will be given at any point
     during the challenge for any reason.

                   Participants Who Have Not Participated In Previous Ultimate Loser’s
                              Must Visit Their Physician Before Participation
                             Sports Academy Ultimate Loser 6
                                            Presented by: Sports Academy
                                     You could win up to $10,000 in cash and prizes!

                                              Please Read Carefully
11. Prizes: Weekly competition prizes will be awarded to top finishing team.
                                  A.                Overall Prizes: Prizes May Change Based On Registration.
                                              a.    Grand Prizes:
                                                            i.   Top Individual - $5,000.00
                                                           ii.   Second Place: Top Male: $750      Top Female: $750
                                              b.    Top Eliminated Individual - $500.00 – must continue to come to workouts and weigh-ins to be
                                                    eligible. Cannot miss more than 10 workouts or 4 weigh-ins.

12. Participant accepts full responsibility for use of Sports Academy & Racquet Club, Inc., and Planet Fitness, Inc., its equipment and services. I also
     attest that I am physically able to undertake any and all physical exercise that I may perform at Sports Academy & Racquet Club, Inc., Planet
     Fitness, Inc. facilities and agree to hold harmless Sports Academy & Racquet Club, Planet Fitness Inc., its agents, affiliates and employees from any
     and all liability for any claims, injuries, damages, action or causes of action, whatsoever, arising to myself or my property or of such usage of the
     Sports Academy & Racquet Club, Inc. Competition and prizes are subject to enrollment and may change at any time at the Directors discretion.
     Prizes may be added to competition at any time without notice, but if prizes are reduced at any time, Director will inform participants by email.
     Any person previously enrolled in a Bodybugg/Ultimate Loser Challenge that has been awarded cash/prizes valued more than $1000.00 may enroll
     in this challenge, but is not eligible to win any cash prizes.

________________________________________________________________________                                     _______________________________
Signature of Applicant                                                                                       Date

Printed Name

________________________________________________________________________                                     _______________________________
Doctor or Physician Signature                                                                                Date

Printed Doctor or Physician Name

                   Participants Who Have Not Participated In Previous Ultimate Loser’s
                              Must Visit Their Physician Before Participation
                      Sports Academy Ultimate Loser 6
                                            Contest Structure:

     Registration: Starts September 7th, 2009 and ends October 7th, 2009 @ 3:00 pm or when teams are
     Set-Up Meeting: Saturday October 10th at 8:00 am to 10:00 am at USU Computer Lab
             -       Trainer Introductions
             -       Set Up/Introduction
             -       First group meeting where participants will see teammates and meet trainers.
     Competition Begins October 12th and ends December 19th, 2009.
             -       Initial measurements and first workout - Monday Oct 12th with Competition
                     Director during your team training time.
             -       Last Weigh-in will be December 18th during your workout time. This day you will
                     need to plan on 1 ½ hours. You will have a workout, so do not come dehydrated,
                     starved, etc… You will be worked out and then weighed in wearing the workout
                     clothes you are wearing.
             -       Weekly Structure:
                     o Monday Group Workout.
                     o Tuesday Group Workout
                     o Wednesday Fitness Challenge – head to head weeks will have a regular workout day.
                     o Thursday Group Workout
                     o Friday Group Workout and Weigh-in with trainer.
                     o Saturday Competitions and Seminars.
                               October 10rd – Initial Set up
                               October 17th – Head to Head Fitness Challenge – location to be announced.
                               October 24th – Nutrition Seminar – in dance room.
                               November 7th – Produce Seminar – in dance room.
                               November 14th – Head to Head Fitness Challenge – location to be announced.
                               November 21st – Fitness Seminar – in dance room
                               December 5th - Head to Head Fitness Challenge – location to be announced.
                               December 19th – Final Results and Prizes Awarded – in dance room.
                               All seminars and competitions start at 8:00am and last approximately one hour.

             -       Participants must attend final weigh-in and Final Saturday Results to be awarded
                     prize(s) on December 18th and December 19th.
             -       There will be no workouts On November 26th and 27th. No points will be awarded.

           A note for parents: If you have children we offer Kids Klub, which is club daycare.
In order to use Kids Klub you must remain in SARC facilities. If your trainer is taking you outside SARC
          facilities please pre arrange alternate daycare. It costs 50 cents per hour per child and
     reservations can be made 24 hours in advance. SARC cannot guarantee Kids Klub availability.

                 Participants Who Have Not Participated In Previous Ultimate Loser’s
                            Must Visit Their Physician Before Participation

To top