Student Sign up for a Strength Center Membership
Student ID Number: (e.g.333445555) Sport Mens Baseball Mens Basketball Mens Cross Country Mens Football Mens Swimming Mens Tennis Mens Track and Field Mens Wrestling Womens Basketball Womens Cross Country Womens Gymnastics Womens Soccer Womens Softball Womens Swimming Womens Tennis Womens Track and Field Womens Volleyball research
E-mail (university email please)
First Name:
Last Name:
Select membership: Select One Summer (5/17-8/15/08) $60
Athletic Assessment Data Waiver/Informed Consent
I voluntarily agree to perform the following physical performance tests and assessments under the supervision of the Strength and Conditioning staff at the University of Wisconsin-La Crosse. I have been informed that my data may be used in the future for professional publications and presentations for educational or research purposes. I have also been informed that my identity shall not be revealed, and that data will be analyzed and presented in group form only.
I acknowledge that the use of such data will improve the knowledge base of the strength and conditioning program, and may enhance its ability to improve my athletic performance or that of others.
Choose One Below I Accept I Decline
ID validation of your membership will occur by 9:00 AM the next business day. Memberships are non-refundable.
I am aware and appreciate that there are risks of injury involved in my participation in the strength and conditioning program at the University of Wisconsin at La Crosse. Clicking on "Submit" is intended to make me aware of my responsibilities in preventing potential injuries or harm, reporting actual injuries, and complying with the treatment plan of my health care providers and indicates that I understand and appreciate the risks involved with my participation. I understand that this includes the risk of brain and spinal cord injury that may result in paralysis, other permanent injury, or possibly death.
I further, hereby certify that I am physically fit to participate in the strength and conditioning programs offered in the UW-L Strength and Conditioning Center.
I do hereby agree to hold harmless and indemnify the State of Wisconsin, the Board of Regents of the University of Wisconsin System, and the University of Wisconsin-La Crosse, their officers, agents and employees, from any and all liability, loss, damages, costs, or expenses which are sustained or incurred by me, and which may include damage to my personal property, personal injury or death, arising out of my actions in the course of participation. (Adapted; Baechle, Thomas R. Essentials of Strength Training and Conditioning Human Kinetics 506,1994)
Completion of the membership form will enable the strength center membership privilege to be assigned.