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2025 Membership and Athletes Medical Profile

Your Details

Name
Address

Membership

Membership Type?

Athlete Medical Profile

As a Run Club affiliated with Athletic Ontario we are required to obtain a Medical Profile of each of our athletes. The information provided in this form will be kept private and will only be shared with the coaches and used in the case of an unexpected emergency.

At the very least we require an emergency contact name and number. Holding back relevant information may delay emergency services providing you with appropriate treatment.

I Identify as

Emergency Contact Details

Medical History

Past Medical History

Do you have any of the following?

Privacy

In our weekly newsletters we usually give a shout out to club members who have completed races. If you do not want this to happen please check the box below.

Privacy

Running Survey

What type of running do you enjoy the most?
What distance do you like to run?

Waiver

I am aware that participating in the activities and sports, without limitation, offered by or associated with the Toronto Harriers, exposes me to many inherent risks, dangers and hazards including COVID-19.

By engaging in any activities offered by or associated with the Toronto Harriers, I freely accept and fully assume all inherent risks, dangers and hazards and the possibility of personal injury, death, property damage or loss resulting there from.

In consideration of the acceptance of my application for registration as a member of the Toronto Harriers, I hereby agree as follows:

1. To waive any and all claims that I have or may in the future have against the Toronto Harriers, and its directors, officers, employees, agents, representatives, assigns and successors.

2. To release the Toronto Harriers, and its directors, officers, employees, agents, representatives, assigns and successors from any and all liability for any loss, damage, injury or expense that I may suffer or that my next of kin may suffer, as a result of my participation in activities and sports offered by the Toronto Harriers, due to any cause whatsoever including but not limited to, negligence, breach of contract, and / or breach of statutory duty of care, on the part of the Toronto Harriers and its directors, officers, employees, agents, representatives, assigns and successors.

3. To hold harmless and indemnify the Toronto Harriers, and its directors, officers, employees, agents, representatives, assigns and successors from any and all liability for any property damage or personal injury to any third party, resulting from my activities and my participation in the activities offered by or associated with the Toronto Harriers.

4. That this waiver shall be effecting and binding upon any heirs, next of kin, executors, administrators and assigns in the event of my death.

5. l have read and understood this waiver prior to agreeing to it. I am waiving certain legal rights which I or any heirs, next of kin, executors, administrators and assigns may have against the Toronto Harriers and its directors, officers, employees, agents, representatives, assigns and successors.

6. To comply with all rules and regulations of the Toronto Harriers, the country of Canada, the Province of Ontario and Public Health authorities concerning matters of health and safety, especially as they relate to COVID-19.

Waiver Agreement

Payment

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