  {"id":5591,"date":"2023-08-07T10:56:59","date_gmt":"2023-08-07T15:56:59","guid":{"rendered":"https:\/\/uwm.edu\/publichealth\/?page_id=5591"},"modified":"2025-11-26T10:04:26","modified_gmt":"2025-11-26T16:04:26","slug":"risk-waiver-form","status":"publish","type":"page","link":"https:\/\/uwm.edu\/publichealth\/fitwell-courses\/risk-waiver-form\/","title":{"rendered":"FitWell Risk Waiver"},"content":{"rendered":"\n<section class=\"uwm-u-py-0\"><div class=\"uwm-l-container--base uwm-l-container--overflow-hidden\">\n<div class=\"uwm-l-row\">\n<div class=\"uwm-l-col\">\n<p>This form below must be filled out for <strong>each<\/strong> individual FitWell Class a student is enrolled in, <strong>every<\/strong> semester. Failure to fill this form out <em>completely<\/em> and <em>correctly<\/em> will negatively impact your ability to participate in the course activities and <strong>your grade<\/strong>. This is an official form between you and the University. It must be filled out <strong>correctly<\/strong>, so please double-check the instructor name, section and course number. <\/p>\n\n\n\n<p>After you submit, you may want to <strong>screenshot your Confirmation Page<\/strong> for your instructor. Your instructor may ask for this to confirm that you filled out your form correctly on the first day of class activities. <br><br><em>You can not participate in course activities until this form is completed correctly. <\/em><\/p>\n\n\n\n<p>If you don&#8217;t know your Course Number or Section\/Lecture Number, you can find it in the top left corner of your Canvas Class page, in your course syllabus, or in PAWS. <\/p>\n\n\n\n<div class=\"uwm-p-notice uwm-p-notice--info\"><i class=\"fa-solid fa-circle-info fa-fw\"><\/i><div class=\"uwm-p-notice--content\"><div class=\"uwm-p-notice--message\">This form is a basic web-based form so if the form doesn&#8217;t work for you, please try another browser or different device. (No 51ÁÔÆæ login is required so it can be done on most devices and most browsers.)<\/div><\/div><\/div>\n<\/div>\n\n\n\n<div class=\"uwm-l-col uwm-l-col--4 uwm-l-offset--1\"><nav aria-label=\"Sidebar\" class=\"uwm-p-navigation-list uwm-p-navigation-list--gold-border \"><div class=\"uwm-p-navigation-list--title\">Resources<\/div><ul>\n<li class=''><a href=\"https:\/\/uwm.edu\/publichealth\/fitwell-courses\/\" class=\"\" rel=\"\" target=\"\"><span>View all FitWell Courses<\/span><\/a><\/li>\n\n<li class=''><a href=\"https:\/\/uwm.edu\/paws\" class=\"\" rel=\"\" target=\"\"><span>PAWS<\/span><\/a><\/li>\n\n<li class=''><a href=\"https:\/\/uwm.edu\/canvas\" class=\"\" rel=\"\" target=\"\"><span>Canvas<\/span><\/a><\/li>\n\n<li class=''><a href=\"https:\/\/instagram.com\/uwmfitwell\" class=\"\" rel=\"\" target=\"\"><span>Follow us on Instagram<\/span><\/a><\/li>\n<\/ul><\/nav><\/div>\n<\/div>\n\n\n<script type=\"text\/javascript\">\n\/* <![CDATA[ *\/\nvar gform;gform||(document.addEventListener(\"gform_main_scripts_loaded\",function(){gform.scriptsLoaded=!0}),document.addEventListener(\"gform\/theme\/scripts_loaded\",function(){gform.themeScriptsLoaded=!0}),window.addEventListener(\"DOMContentLoaded\",function(){gform.domLoaded=!0}),gform={domLoaded:!1,scriptsLoaded:!1,themeScriptsLoaded:!1,isFormEditor:()=>\"function\"==typeof InitializeEditor,callIfLoaded:function(o){return!(!gform.domLoaded||!gform.scriptsLoaded||!gform.themeScriptsLoaded&&!gform.isFormEditor()||(gform.isFormEditor()&&console.warn(\"The use of gform.initializeOnLoaded() is deprecated in the form editor context and will be removed in Gravity Forms 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d=gform.hooks[o][r];null==n&&(n=r+\"_\"+d.length),gform.hooks[o][r].push({tag:n,callable:e,priority:t=null==t?10:t})},doHook:function(r,o,e){var t;if(e=Array.prototype.slice.call(e,1),null!=gform.hooks[r][o]&&((o=gform.hooks[r][o]).sort(function(o,r){return o.priority-r.priority}),o.forEach(function(o){\"function\"!=typeof(t=o.callable)&&(t=window[t]),\"action\"==r?t.apply(null,e):e[0]=t.apply(null,e)})),\"filter\"==r)return e[0]},removeHook:function(o,r,t,n){var e;null!=gform.hooks[o][r]&&(e=(e=gform.hooks[o][r]).filter(function(o,r,e){return!!(null!=n&&n!=o.tag||null!=t&&t!=o.priority)}),gform.hooks[o][r]=e)}});\n\/* ]]> *\/\n<\/script>\n\n                <div class='gf_browser_unknown gform_wrapper gravity-theme gform-theme--no-framework' data-form-theme='gravity-theme' data-form-index='0' id='gform_wrapper_6' style='display:none'>\n                        <div class='gform_heading'>\n                            <h2 class=\"gform_title\">FitWell Risk Waiver<\/h2>\n                            <p class='gform_description'><\/p>\n                        <\/div><form method='post' enctype='multipart\/form-data'  id='gform_6'  action='\/publichealth\/wp-json\/wp\/v2\/pages\/5591' data-formid='6' novalidate><div class='gf_invisible ginput_recaptchav3' data-sitekey='6Let4LkmAAAAAMDytJZITec55NB97k2BiShMXqPE' data-tabindex='0'><input id=\"input_4a79835752d484794e1f1310d08e6042\" class=\"gfield_recaptcha_response\" type=\"hidden\" name=\"input_4a79835752d484794e1f1310d08e6042\" value=\"\"\/><\/div>\n                        <div class='gform-body gform_body'><div id='gform_fields_6' class='gform_fields top_label form_sublabel_below description_below validation_below'><div id=\"field_6_47\" class=\"gfield gfield--type-honeypot gform_validation_container field_sublabel_below gfield--has-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_6_47'>Company<\/label><div class='ginput_container'><input name='input_47' id='input_6_47' type='text' value='' autocomplete='new-password'\/><\/div><div class='gfield_description' id='gfield_description_6_47'>This field is for validation purposes and should be left unchanged.<\/div><\/div><div id=\"field_6_37\" class=\"gfield gfield--type-select gfield--input-type-select gfield_contains_required field_sublabel_below gfield--has-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_6_37'>Semester\/Class Starts<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_37' id='input_6_37' class='large gfield_select'  aria-describedby=\"gfield_description_6_37\"  aria-required=\"true\" aria-invalid=\"false\" ><option value='' selected='selected' class='gf_placeholder'>Choose the Semester &amp; When the Class Starts<\/option><option value='Spring 2026 - Class Starts in January' >Spring 2026 &#8211; Class Starts in January<\/option><option value='Spring 2026 - Class Starts in March or later' >Spring 2026 &#8211; Class Starts in March or later<\/option><option value='Summer 2026 - Class Starts in May or later' >Summer 2026 &#8211; Class Starts in May or later<\/option><option value='Fall 2026 - Class Starts in September' >Fall 2026 &#8211; Class Starts in September<\/option><option value='Fall 2026 - Class Starts in October or later' >Fall 2026 &#8211; Class Starts in October or later<\/option><option value='UWinteriM 2027 - Class Starts in January' >UWinteriM 2027 &#8211; Class Starts in January<\/option><option value='Spring 2027 - Class Starts in March or later' >Spring 2027 &#8211; Class Starts in March or later<\/option><option value='Spring 2027 - Class Starts in March or later' >Spring 2027 &#8211; Class Starts in March or later<\/option><option value='Summer 2026 - Class Starts in May or later' >Summer 2026 &#8211; Class Starts in May or later<\/option><option value='Other' >Other<\/option><\/select><\/div><div class='gfield_description' id='gfield_description_6_37'>Please choose the Semester and when your class starts from the drop down. <\/div><\/div><div id=\"field_6_13\" class=\"gfield gfield--type-select gfield--input-type-select gfield_contains_required field_sublabel_below gfield--has-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_6_13'>Class Title<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_13' id='input_6_13' class='large gfield_select'  aria-describedby=\"gfield_description_6_13\"  aria-required=\"true\" aria-invalid=\"false\" ><option value='' selected='selected' class='gf_placeholder'>Select the Class Title<\/option><option value='Backpacking' >Backpacking<\/option><option value='Badminton' >Badminton<\/option><option value='Basketball' >Basketball<\/option><option value='Coaching Basketball Philosophies' >Coaching Basketball Philosophies<\/option><option value='Bicycle Maintentance' >Bicycle Maintentance<\/option><option value='Bicycle Road Riding' >Bicycle Road Riding<\/option><option value='Off-Road Bicycling' >Off-Road Bicycling<\/option><option value='Billiards &amp; Pool' >Billiards &amp; Pool<\/option><option value='Intermediate Billiards &amp; Pool' >Billiards &amp; Pool, Intermediate<\/option><option value='Bowling I' >Bowling I<\/option><option value='Bowling II' >Bowling II<\/option><option value='Bradford Beach Sports' >Bradford Beach Sports<\/option><option value='Brazilian Jiu-Jitsu' >Brazilian Jiu-Jitsu<\/option><option value='Brazilian Jiu-Jitsu II' >Brazilian Jiu-Jitsu II<\/option><option value='Breathwork for Wellness, Vitality and Stress Reduction' >Breathwork for Wellness, Vitality and Stress Reduction<\/option><option value='Chess: Focus on Tactics' >Chess: Focus on Tactics<\/option><option value='Cooking Healthy Foods' >Cooking Healthy Foods<\/option><option value='Cooking in College' >Cooking in College: Beyond Ramen<\/option><option value='Ballroom Dance I' >Dance: Ballroom Dance I<\/option><option value='Salsa, Merengue &amp; Bachata' >Dance: Salsa, Merengue &amp; Bachata<\/option><option value='Digital Photography Fundamentals' >Digital Photography Fundamentals<\/option><option value='East Indian Vegetarian Cooking' >East Indian Vegetarian Cooking<\/option><option value='Fitness and Wellness for Life' >Fitness and Wellness for Life<\/option><option value='Fitness Walking' >Fitness Walking<\/option><option value='Functional Movement' >Functional Movement<\/option><option value='Introduction to Floral Design' >Introduction to Floral Design<\/option><option value='Golf' >Golf<\/option><option value='Handball' >Handball<\/option><option value='Handball II' >Handball II<\/option><option value='Hiking WI State Trails' >Hiking WI State Trails<\/option><option value='Introduction to Relaxation &amp; Meditation' >Meditation &#8211; Introduction to Relaxation &amp; Meditation<\/option><option value='Meditation in the 21st Century' >Meditation in the 21st Century<\/option><option value='Meditation with a Touch of Yoga' >Meditation with a Touch of Yoga<\/option><option value='Meditation, Mindfulness and Stress Reduction' >Meditation, Mindfulness and Stress Reduction<\/option><option value='Mind Body Awareness' >Meditation &#8211; Mind Body Awareness<\/option><option value='Rewire Your Anxious Mind for Peace: Using Mindfulness to Reduce Anxiety and Depression' >Meditation &#8211; Rewire Your Anxious Mind for Peace: Using Mindfulness to Reduce Anxiety and Depression<\/option><option value='Meditation - Be Kind to Your Mind' >Meditation &#8211; Be Kind to Your Mind<\/option><option value='Meditation - Calm Fear and Stress with Kindfulness' >Meditation &#8211; Calm Fear and Stress with Kindfulness<\/option><option value='Meditation - Resilience in College and Beyond' >Meditation &#8211; Resilience in College and Beyond<\/option><option value='' >Mindful Movement<\/option><option value='Mindful Movement' >Mindful Movement<\/option><option value='Muay Thai Kickboxing' >Muay Thai Kickboxing<\/option><option value='PTrain PTEC' >Personal Training Education Course<\/option><option value='Physical Conditioning' >Physical Conditioning<\/option><option value='Pickleball' >Pickleball<\/option><option value='Racquetball' >Racquetball<\/option><option value='Rock Climbing, Basic' >Rock Climbing, Basic<\/option><option value='Rocket League for Beginners' >Rocket League for Beginners<\/option><option value='Running for Fun and Fitness' >Running for Fun and Fitness<\/option><option value='Running, Introduction to' >Running, Introduction to<\/option><option value='Running, Introduction to' >Running, Introduction to<\/option><option value='Beginning Scuba' >SCUBA &#8211; Beginning Scuba<\/option><option value='Scuba Equipment Maintenance Specialty' >SCUBA &#8211; Equipment Maintenance Specialty<\/option><option value='Advanced Dive Theory' selected='selected'>SCUBA &#8211; Advanced Dive Theory<\/option><option value='Advanced Open Water Diver' >SCUBA &#8211; Advanced Open Water Diver<\/option><option value='Diving-Enriched Air (Nitrox)' >SCUBA &#8211; Diving-Enriched Air (Nitrox)<\/option><option value='SCUBA: Underwater Photography' >SCUBA: Underwater Photography<\/option><option value='Self-Defense' >Self-Defense<\/option><option value='Intermediate Snowboarding' >Snowboarding, Intermediate<\/option><option value='Indoor Soccer' >Soccer I, Indoor<\/option><option value='Outdoor Soccer I or II' >Soccer I or II, Outdoor<\/option><option value='Strategy Games' >Strategy Games<\/option><option value='Swim I' >Swim I<\/option><option value='Swim II' >Swim II<\/option><option value='Tennis I' >Tennis I<\/option><option value='Total Body Conditioning' >Total Body Conditioning<\/option><option value='Volleyball' >Volleyball<\/option><option value='Volleyball II' >Volleyball II<\/option><option value='Weight Training  I' >Weight Training  I<\/option><option value='Yoga I' >Yoga I<\/option><option value='Yoga II' >Yoga II<\/option><option value='Deep Stretch Yoga' >Deep Stretch Yoga<\/option><option value='Other' >Other<\/option><\/select><\/div><div class='gfield_description' id='gfield_description_6_13'>Please make sure to select the correct information and fill this entire form correctly. Failure to complete the form correctly will result in not being able to participate in the class until the form is re-submitted with accurate information. You can find all the details needed in PAWS or Canvas. <\/div><\/div><div id=\"field_6_9\" class=\"gfield gfield--type-select gfield--input-type-select gfield_contains_required field_sublabel_below gfield--has-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_6_9'>Course Number<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_9' id='input_6_9' class='large gfield_select'  aria-describedby=\"gfield_description_6_9\"  aria-required=\"true\" aria-invalid=\"false\" ><option value='' selected='selected' class='gf_placeholder'>Select the Course Number<\/option><option value='110- Physical Conditioning' >110- Physical Conditioning<\/option><option value='112- Yoga I' >112- Yoga I<\/option><option value='113- Yoga II' >113- Yoga II<\/option><option value='114- Weight Training I' >114- Weight Training I<\/option><option value='120- Swim I' >120- Swim I<\/option><option value='121- Swim II' >121- Swim II<\/option><option value='126- Beginning Scuba' >126- Beginning Scuba<\/option><option value='130- Ballroom Dance I' >130- Ballroom Dance I<\/option><option value='161- Bowling I' >161- Bowling I<\/option><option value='162- Bowling II' >162- Bowling II<\/option><option value='166- Golf' >166- Golf<\/option><option value='174- Self-Defense' >174- Self-Defense<\/option><option value='176- Basketball' >176- Basketball<\/option><option value='179- Handball' >179- Handball<\/option><option value='180- Racquetball' >180- Racquetball<\/option><option value='188- Indoor Soccer I' >188- Indoor Soccer I<\/option><option value='191- Volleyball' >191- Volleyball<\/option><option value='202 - SCUBA Activities' >202 &#8211; SCUBA Activities<\/option><option value='289- General Recreation Activities' >289- General Recreation Activities<\/option><option value='291- Recreational Arts and Crafts' >291- Recreational Arts and Crafts<\/option><option value='292- Social and Creative Dance' >292- Social and Creative Dance<\/option><option value='293- Martial Arts' >293- Martial Arts<\/option><option value='294- Wilderness Advntr\/Outdr Actvty' >294- Wilderness Advntr\/Outdr Actvty<\/option><option value='295- Organized Sport' >295- Organized Sport<\/option><option value='296- Exercise &amp; Fitness Activities' >296- Exercise &amp; Fitness Activities<\/option><option value='298- Meditation, Relaxatn, Wllnss' >298- Meditation, Relaxatn, Wllnss<\/option><\/select><\/div><div class='gfield_description' id='gfield_description_6_9'>In Canvas when you have the class page opened on a computer, it would be the first set of numbers before the dash in the top left corner. Failure to complete the form correctly will result in not being able to participate in the class until the form is re-submitted with accurate information. <\/div><\/div><div id=\"field_6_33\" class=\"gfield gfield--type-number gfield--input-type-number gfield_contains_required field_sublabel_below gfield--has-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_6_33'>Lecture\/Section Number<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_number'><input name='input_33' id='input_6_33' type='number' step='any' min='100' max='600' value='' class='large'    placeholder='Enter the Section\/Lecture Number - This is a 3 digit number only.' aria-required=\"true\" aria-invalid=\"false\" aria-describedby=\"gfield_instruction_6_33 gfield_description_6_33\" \/><div class='gfield_description instruction ' id='gfield_instruction_6_33'>Please enter a number from <strong>100<\/strong> to <strong>600<\/strong>.<\/div><\/div><div class='gfield_description' id='gfield_description_6_33'>You can find your Section\/Lecture Number in Canvas or PAWS (it&#8217;s the second set of three numbers beside the course number). In Canvas, it is located in the top left corner in blue (or top center of the page in white) on your specific class page. *Please enter the correct 3 digit  number only. This is not the five digit Class Number. This also doesn&#8217;t include the Course number.*  Failure to complete the form correctly will result in not being able to participate in the class until the form is re-submitted with accurate information. <\/div><\/div><div id=\"field_6_12\" class=\"gfield gfield--type-select gfield--input-type-select gfield_contains_required field_sublabel_below gfield--has-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_6_12'>Instructor Name<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_12' id='input_6_12' class='large gfield_select'  aria-describedby=\"gfield_description_6_12\"  aria-required=\"true\" aria-invalid=\"false\" ><option value='' selected='selected' class='gf_placeholder'>Select the Instructor&#039;s Name<\/option><option value='Achenbach' >Achenbach<\/option><option value='Bartz' >Bartz<\/option><option value='Buckley' >Buckley<\/option><option value='Blahnik' >Blahnik<\/option><option value='Blandino' >Blandino<\/option><option value='Czyzewski' >Czyzewski<\/option><option value='Dagelen' >Dagelen<\/option><option value='Deutsch' >Deutsch<\/option><option value='Filzen' >Filzen<\/option><option value='Gates' >Gates<\/option><option value='Gordon' >Gordon<\/option><option value='Holy-Skaja' >Holy-Skaja<\/option><option value='Kehoe' >Kehoe<\/option><option value='Kelley' >Kelley<\/option><option value='Klipp \/ Ottow' >Klipp \/ Ottow<\/option><option value='Kosmitis' >Kosmitis<\/option><option value='Mack' >Mack<\/option><option value='Martin, Chris' >Martin, Chris<\/option><option value='Martin, Madeline' >Martin, Madeline<\/option><option value='McGrath' >McGrath<\/option><option value='Noll' >Noll<\/option><option value='Olson' >Olson<\/option><option value='Otte, Jerry' >Otte, Jerry<\/option><option value='Otte, Jenny' >Otte, Jenny<\/option><option value='Pack' >Pack<\/option><option value='Penkalski' >Penkalski<\/option><option value='Schwartz' >Schwartz<\/option><option value='Smikowski' >Smikowski<\/option><option value='Sommers' >Sommers<\/option><option value='Sorce' >Sorce<\/option><option value='Sweeney' >Sweeney<\/option><option value='Thompson' >Thompson<\/option><option value='Umbs' >Umbs<\/option><option value='Van Linda' >Van Linda<\/option><option value='Walecki' >Walecki<\/option><option value='Waltz' >Waltz<\/option><option value='Wurster' >Wurster<\/option><option value='Zarate' >Zarate<\/option><\/select><\/div><div class='gfield_description' id='gfield_description_6_12'>Please double check your instructors name is the name of the primary instructor. <\/div><\/div><fieldset id=\"field_6_2\" class=\"gfield gfield--type-name gfield--input-type-name gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Participant&#039;s Name<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_complex ginput_container ginput_container--name no_prefix has_first_name no_middle_name has_last_name no_suffix gf_name_has_2 ginput_container_name gform-grid-row' id='input_6_2'>\n                            \n                            <span id='input_6_2_3_container' class='name_first gform-grid-col gform-grid-col--size-auto' >\n                                                    <input type='text' name='input_2.3' id='input_6_2_3' value=''   aria-required='true'     \/>\n                                                    <label for='input_6_2_3' class='gform-field-label gform-field-label--type-sub '>First<\/label>\n                                                <\/span>\n                            \n                            <span id='input_6_2_6_container' class='name_last gform-grid-col gform-grid-col--size-auto' >\n                                                    <input type='text' name='input_2.6' id='input_6_2_6' value=''   aria-required='true'     \/>\n                                                    <label for='input_6_2_6' class='gform-field-label gform-field-label--type-sub '>Last<\/label>\n                                                <\/span>\n                            \n                        <\/div><\/fieldset><div id=\"field_6_4\" class=\"gfield gfield--type-email gfield--input-type-email gfield_contains_required field_sublabel_below gfield--has-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_6_4'>Participant&#039;s 51ÁÔÆæ Email<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_email'>\n                            <input name='input_4' id='input_6_4' type='email' value='' class='large'    aria-required=\"true\" aria-invalid=\"false\" aria-describedby=\"gfield_description_6_4\" \/>\n                        <\/div><div class='gfield_description' id='gfield_description_6_4'>Please enter your @uwm.edu email address. No other email addresses will be accepted. <\/div><\/div><fieldset id=\"field_6_22\" class=\"gfield gfield--type-consent gfield--type-choice gfield--input-type-consent gfield_contains_required field_sublabel_below gfield--has-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label screen-reader-text gfield_label_before_complex' >I [name entered], desire to participate voluntarily in FitWell Course [course name entered] conducted, directed, supervised or sponsored by the Board of Regents of the University of Wisconsin System, operating as the University of Wisconsin\u2013Milwaukee Zilber College of Public Health FitWell Program (hereinafter referred to as 51ÁÔÆæ), located at Enderis Hall, 2400 E Hartford Ave. These activities will primarily occur at the following locations: Engelmann Gym, 2033 E. Hartford Ave.; Brown Deer Golf Course, 7625 N. Range Line Rd..; Bradford Beach, 2400 N. Lincoln Memorial Dr.; Gordon Park, 2828 N. Humboldt Blvd; Klotsche Center, 3409 N. Downer Ave.;  Milwaukee Turners, Inc., 1034 Vel R. Phillips Ave.; Pavilion, 3409 N. Downer Ave.; Pura Vida BJJ &amp; MMA, 4125 N. Richards St.; Union Recreation Center, 2200 E. 51ÁÔÆæ.; and some activities will be done at your place of residence.  \n\nI UNDERSTAND THAT I AM BEING ASKED TO READ EACH OF THE FOLLOWING PARAGRAPHS CAREFULLY. I UNDERSTAND THAT IF I WISH TO DISCUSS OR ALTER THE TERMS CONTAINED IN THIS AGREEMENT, I MAY CONTACT PROGRAM SUPERVISOR AT TELEPHONE NUMBER 414-227-3123 OR VIA EMAIL AT fit-well@uwm.edu.<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_container ginput_container_consent'><input name='input_22.1' id='input_6_22_1' type='checkbox' value='1'  aria-describedby=\"gfield_consent_description_6_22\" aria-required=\"true\" aria-invalid=\"false\"   \/> <label class=\"gform-field-label gform-field-label--type-inline gfield_consent_label\" for='input_6_22_1' >By signing I agree to the statements below.<\/label><input type='hidden' name='input_22.2' value='By signing I agree to the statements below.' class='gform_hidden' \/><input type='hidden' name='input_22.3' value='16' class='gform_hidden' \/><\/div><div class='gfield_description gfield_consent_description' id='gfield_consent_description_6_22' tabindex='0'>I [name entered], desire to participate voluntarily in FitWell Course [course name entered] conducted, directed, supervised or sponsored by the Board of Regents of the University of Wisconsin System, operating as the University of Wisconsin\u2013Milwaukee Zilber College of Public Health FitWell Program (hereinafter referred to as 51ÁÔÆæ), located at Enderis Hall, 2400 E Hartford Ave. These activities will primarily occur at the following locations: Engelmann Gym, 2033 E. Hartford Ave.; Brown Deer Golf Course, 7625 N. Range Line Rd..; Bradford Beach, 2400 N. Lincoln Memorial Dr.; Gordon Park, 2828 N. Humboldt Blvd; Klotsche Center, 3409 N. Downer Ave.;  Milwaukee Turners, Inc., 1034 Vel R. Phillips Ave.; Pavilion, 3409 N. Downer Ave.; Pura Vida BJJ &amp; MMA, 4125 N. Richards St.; Union Recreation Center, 2200 E. 51ÁÔÆæ.; and some activities will be done at your place of residence.  <br \/>\n<br \/>\nI UNDERSTAND THAT I AM BEING ASKED TO READ EACH OF THE FOLLOWING PARAGRAPHS CAREFULLY. I UNDERSTAND THAT IF I WISH TO DISCUSS OR ALTER THE TERMS CONTAINED IN THIS AGREEMENT, I MAY CONTACT PROGRAM SUPERVISOR AT TELEPHONE NUMBER 414-227-3123 OR VIA EMAIL AT fit-well@uwm.edu.<\/div><\/fieldset><fieldset id=\"field_6_38\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Authorization Method<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_6_38'>\n\t\t\t<div class='gchoice gchoice_6_38_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_38' type='radio' value='Authorize by providing your signature' checked='checked' id='choice_6_38_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_6_38_0' id='label_6_38_0' class='gform-field-label gform-field-label--type-inline'>Authorize by providing your signature<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_6_38_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_38' type='radio' value='Authorize by typing your full name'  id='choice_6_38_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_6_38_1' id='label_6_38_1' class='gform-field-label gform-field-label--type-inline'>Authorize by typing your full name<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_6_39\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_6_39'>Participant&#039;s Full Name<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_39' id='input_6_39' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_6_40\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full field_sublabel_below gfield--has-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_6_40'>Parent or Guardian&#039;s Full Name (If Participant is under 18)<\/label><div class='ginput_container ginput_container_text'><input name='input_40' id='input_6_40' type='text' value='' class='large'  aria-describedby=\"gfield_description_6_40\"    aria-invalid=\"false\"   \/><\/div><div class='gfield_description' id='gfield_description_6_40'>*Only Required if Participant is Under 18<\/div><\/div><fieldset id=\"field_6_5\" class=\"gfield gfield--type-signature gfield--input-type-signature gfield--width-half gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Signature of Participant<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class=\"ginput_container ginput_container_signature\"><input type='hidden' value='' name='input_5' id='input_6_5_signature_filename'\/><div class='gfield_signature_ui_container gform-theme__no-reset--children' ><div id='input_6_5_Container' class='gfield_signature_container' style='height:180px; width:300px; ' ><canvas id=\"input_6_5\" width=\"300\" height=\"180\" style=\"border-style: Dashed; border-width: 2px; border-color: #DDDDDD; background-color:#FFFFFF; cursor: url(https:\/\/uwm.edu\/publichealth\/wp-content\/plugins\/gravityformssignature\/assets\/img\/pen.cur), pointer;\" tabindex=\"0\" aria-label=\"Signature pad\" ><\/canvas><\/div><div id='input_6_5_toolbar' style='margin:5px 0;position:relative;height:20px;width:300px;max-width:100%;'><img id='input_6_5_resetbutton' src='data:image\/png;base64,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' style='cursor:pointer;float:right;height:24px;width:24px;border:0px solid transparent' alt='Clear Signature' role='button' tabindex='0' aria-label='Clear Signature' \/><\/div><input type='hidden' id='input_6_5_data' name='input_6_5_data' value=''><\/div><\/div><\/fieldset><fieldset id=\"field_6_21\" class=\"gfield gfield--type-signature gfield--input-type-signature gfield--width-half field_sublabel_below gfield--has-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Signature of Parent or Guardian (If Participant is under 18)<\/legend><div class=\"ginput_container ginput_container_signature\"><input type='hidden' value='' name='input_21' id='input_6_21_signature_filename'\/><div class='gfield_signature_ui_container gform-theme__no-reset--children' ><div id='input_6_21_Container' class='gfield_signature_container' style='height:180px; width:300px; ' ><canvas id=\"input_6_21\" width=\"300\" height=\"180\" style=\"border-style: Dashed; border-width: 2px; border-color: #DDDDDD; background-color:#FFFFFF; cursor: url(https:\/\/uwm.edu\/publichealth\/wp-content\/plugins\/gravityformssignature\/assets\/img\/pen.cur), pointer;\" tabindex=\"0\" aria-label=\"Signature pad\" aria-describedby=\"gfield_description_6_21\"><\/canvas><\/div><div id='input_6_21_toolbar' style='margin:5px 0;position:relative;height:20px;width:300px;max-width:100%;'><img id='input_6_21_resetbutton' src='data:image\/png;base64,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' style='cursor:pointer;float:right;height:24px;width:24px;border:0px solid transparent' alt='Clear Signature' role='button' tabindex='0' aria-label='Clear Signature' \/><\/div><input type='hidden' id='input_6_21_data' name='input_6_21_data' value=''><\/div><\/div><div class='gfield_description' id='gfield_description_6_21'>*Only Required if Participant is Under 18<\/div><\/fieldset><div id=\"field_6_3\" class=\"gfield gfield--type-date gfield--input-type-date gfield--input-type-datepicker gfield--datepicker-no-icon gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_6_3'>Date<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_date'>\n                            <input name='input_3' id='input_6_3' type='text' value='' class='datepicker gform-datepicker mdy datepicker_no_icon gdatepicker-no-icon'   placeholder='mm\/dd\/yyyy' aria-describedby=\"input_6_3_date_format\" aria-invalid=\"false\" aria-required=\"true\"\/>\n                            <span id='input_6_3_date_format' class='screen-reader-text'>MM slash DD slash YYYY<\/span>\n                        <\/div>\n                        <input type='hidden' id='gforms_calendar_icon_input_6_3' class='gform_hidden' value='https:\/\/uwm.edu\/publichealth\/wp-content\/plugins\/gravityforms\/images\/datepicker\/datepicker.svg'\/><\/div><fieldset id=\"field_6_35\" class=\"gfield gfield--type-consent gfield--type-choice gfield--input-type-consent gfield_contains_required field_sublabel_below gfield--has-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Assumption of Risks<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_container ginput_container_consent'><input name='input_35.1' id='input_6_35_1' type='checkbox' value='1'  aria-describedby=\"gfield_consent_description_6_35\" aria-required=\"true\" aria-invalid=\"false\"   \/> <label class=\"gform-field-label gform-field-label--type-inline gfield_consent_label\" for='input_6_35_1' >I agree to the Assumption of Risks listed below.<\/label><input type='hidden' name='input_35.2' value='I agree to the Assumption of Risks listed below.' class='gform_hidden' \/><input type='hidden' name='input_35.3' value='16' class='gform_hidden' \/><\/div><div class='gfield_description gfield_consent_description' id='gfield_consent_description_6_35' tabindex='0'>I understand that by participating in this FitWell Course [name of course entered above], by its very nature, carries with it certain inherent risks that cannot be eliminated regardless of the care taken to avoid injuries and\/or illness.  This includes activities untaken outside, which may involve uneven, slippery, or difficult terrain, as well as the sudden and unforeseen malfunctioning of any equipment. Some of these also involve strenuous exertions of strength using various muscle groups, some involve quick movement involving speed and change of direction, and others involve sustained physical activity, which places stress on the cardiovascular system. The specific risks vary from one activity to another, but in each activity the risks range from, but are not limited to: 1) minor injuries such as dizziness, nausea, fainting, dehydration, hyperextension, heat stroke, heat fatigue, scratches, scrapes, cuts, lacerations, bruises, contusions, strains and sprains to 2) major injuries such as fractures, broken bones, frostbite, internal organ injuries, musculoskeletal injuries, eye injuries, back injuries, heart attacks, cardiac arrest, concussions to 3) catastrophic injuries including paralysis and death, and 4) illnesses; such as the seasonal flu and coronavirus. I understand that 51ÁÔÆæ has advised me to seek the advice of my physician before participating in this activity. I understand that I have been advised to have health and accident insurance in effect and that no such coverage is provided for me by 51ÁÔÆæ.  I KNOW, UNDERSTAND, AND APPRECIATE THE RISKS THAT ARE INHERENT IN THE ABOVE-LISTED Sport &amp; Recreation Class [name of class entered above]  ACTIVITIES.  I HEREBY ASSERT THAT MY PARTICIPATION IS VOLUNTARY AND THAT I KNOWINGLY ASSUME ALL SUCH RISKS.<\/div><\/fieldset><fieldset id=\"field_6_41\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Authorization Method &#8211; Assumption of Risks<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_6_41'>\n\t\t\t<div class='gchoice gchoice_6_41_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_41' type='radio' value='Authorize by providing your signature' checked='checked' id='choice_6_41_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_6_41_0' id='label_6_41_0' class='gform-field-label gform-field-label--type-inline'>Authorize by providing your signature<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_6_41_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_41' type='radio' value='Authorize by typing your full name'  id='choice_6_41_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_6_41_1' id='label_6_41_1' class='gform-field-label gform-field-label--type-inline'>Authorize by typing your full name<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_6_42\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_6_42'>Participant&#039;s Full Name &#8211; Assumption of Risks<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_42' id='input_6_42' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_6_43\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full field_sublabel_below gfield--has-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_6_43'>Parent or Guardian&#039;s Full Name (If Participant is under 18)<\/label><div class='ginput_container ginput_container_text'><input name='input_43' id='input_6_43' type='text' value='' class='large'  aria-describedby=\"gfield_description_6_43\"    aria-invalid=\"false\"   \/><\/div><div class='gfield_description' id='gfield_description_6_43'>*Only Required if Participant is Under 18<\/div><\/div><fieldset id=\"field_6_23\" class=\"gfield gfield--type-signature gfield--input-type-signature gfield--width-half gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Signature of Participant- Assumption of Risks<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class=\"ginput_container ginput_container_signature\"><input type='hidden' value='' name='input_23' id='input_6_23_signature_filename'\/><div class='gfield_signature_ui_container gform-theme__no-reset--children' ><div id='input_6_23_Container' class='gfield_signature_container' style='height:180px; width:300px; ' ><canvas id=\"input_6_23\" width=\"300\" height=\"180\" style=\"border-style: Dashed; border-width: 2px; border-color: #DDDDDD; background-color:#FFFFFF; cursor: url(https:\/\/uwm.edu\/publichealth\/wp-content\/plugins\/gravityformssignature\/assets\/img\/pen.cur), pointer;\" tabindex=\"0\" aria-label=\"Signature pad\" ><\/canvas><\/div><div id='input_6_23_toolbar' style='margin:5px 0;position:relative;height:20px;width:300px;max-width:100%;'><img id='input_6_23_resetbutton' src='data:image\/png;base64,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' style='cursor:pointer;float:right;height:24px;width:24px;border:0px solid transparent' alt='Clear Signature' role='button' tabindex='0' aria-label='Clear Signature' \/><\/div><input type='hidden' id='input_6_23_data' name='input_6_23_data' value=''><\/div><\/div><\/fieldset><fieldset id=\"field_6_24\" class=\"gfield gfield--type-signature gfield--input-type-signature gfield--width-half field_sublabel_below gfield--has-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Signature of Parent or Guardian (If Participant is under 18)<\/legend><div class=\"ginput_container ginput_container_signature\"><input type='hidden' value='' name='input_24' id='input_6_24_signature_filename'\/><div class='gfield_signature_ui_container gform-theme__no-reset--children' ><div id='input_6_24_Container' class='gfield_signature_container' style='height:180px; width:300px; ' ><canvas id=\"input_6_24\" width=\"300\" height=\"180\" style=\"border-style: Dashed; border-width: 2px; border-color: #DDDDDD; background-color:#FFFFFF; cursor: url(https:\/\/uwm.edu\/publichealth\/wp-content\/plugins\/gravityformssignature\/assets\/img\/pen.cur), pointer;\" tabindex=\"0\" aria-label=\"Signature pad\" aria-describedby=\"gfield_description_6_24\"><\/canvas><\/div><div id='input_6_24_toolbar' style='margin:5px 0;position:relative;height:20px;width:300px;max-width:100%;'><img id='input_6_24_resetbutton' src='data:image\/png;base64,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' style='cursor:pointer;float:right;height:24px;width:24px;border:0px solid transparent' alt='Clear Signature' role='button' tabindex='0' aria-label='Clear Signature' \/><\/div><input type='hidden' id='input_6_24_data' name='input_6_24_data' value=''><\/div><\/div><div class='gfield_description' id='gfield_description_6_24'>*Only Required if Participant is Under 18<\/div><\/fieldset><div id=\"field_6_25\" class=\"gfield gfield--type-date gfield--input-type-date gfield--input-type-datepicker gfield--datepicker-no-icon gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_6_25'>Date<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_date'>\n                            <input name='input_25' id='input_6_25' type='text' value='' class='datepicker gform-datepicker mdy datepicker_no_icon gdatepicker-no-icon'   placeholder='mm\/dd\/yyyy' aria-describedby=\"input_6_25_date_format\" aria-invalid=\"false\" aria-required=\"true\"\/>\n                            <span id='input_6_25_date_format' class='screen-reader-text'>MM slash DD slash YYYY<\/span>\n                        <\/div>\n                        <input type='hidden' id='gforms_calendar_icon_input_6_25' class='gform_hidden' value='https:\/\/uwm.edu\/publichealth\/wp-content\/plugins\/gravityforms\/images\/datepicker\/datepicker.svg'\/><\/div><fieldset id=\"field_6_18\" class=\"gfield gfield--type-consent gfield--type-choice gfield--input-type-consent gfield_contains_required field_sublabel_below gfield--has-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Hold Harmless, Indemnity and Release<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_container ginput_container_consent'><input name='input_18.1' id='input_6_18_1' type='checkbox' value='1'  aria-describedby=\"gfield_consent_description_6_18\" aria-required=\"true\" aria-invalid=\"false\"   \/> <label class=\"gform-field-label gform-field-label--type-inline gfield_consent_label\" for='input_6_18_1' >I agree to the Hold Harmless, Indemnity and Release below.<\/label><input type='hidden' name='input_18.2' value='I agree to the Hold Harmless, Indemnity and Release below.' class='gform_hidden' \/><input type='hidden' name='input_18.3' value='16' class='gform_hidden' \/><\/div><div class='gfield_description gfield_consent_description' id='gfield_consent_description_6_18' tabindex='0'>In consideration of 51ÁÔÆæ permission for me to voluntarily participate in the FitWell Course [name of course entered above], today and on all future dates, I, for myself, my heirs, personal representatives or assigns, agree to defend, hold harmless, indemnify and release 51ÁÔÆæ, and their officers, employees, agents, and volunteers, from and against any and all claims, demands, actions, or causes of action of any sort on account of damage to personal property, or personal injury, or death which may result from my participation in the the FitWell Course [name of class entered above]. This release includes claims based on the negligence of 51ÁÔÆæ, and their officers, employees, agents, and volunteers, but expressly does not include claims based on their intentional misconduct or gross negligence.  <br \/>\nI UNDERSTAND THAT BY AGREEING TO THIS CLAUSE I AM RELEASING CLAIMS AND GIVING UP SUBSTANTIAL RIGHTS, INCLUDING MY RIGHT TO SUE.<\/div><\/fieldset><fieldset id=\"field_6_44\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Authorization Method &#8211; Hold Harmless, Indemnity and Release<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_6_44'>\n\t\t\t<div class='gchoice gchoice_6_44_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_44' type='radio' value='Authorize by providing your signature' checked='checked' id='choice_6_44_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_6_44_0' id='label_6_44_0' class='gform-field-label gform-field-label--type-inline'>Authorize by providing your signature<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_6_44_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_44' type='radio' value='Authorize by typing your full name'  id='choice_6_44_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_6_44_1' id='label_6_44_1' class='gform-field-label gform-field-label--type-inline'>Authorize by typing your full name<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_6_45\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_6_45'>Participant&#039;s Full Name &#8211; Hold Harmless, Indemnity and Release<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_45' id='input_6_45' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_6_46\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full field_sublabel_below gfield--has-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_6_46'>Parent or Guardian&#039;s Full Name (If Participant is under 18)<\/label><div class='ginput_container ginput_container_text'><input name='input_46' id='input_6_46' type='text' value='' class='large'  aria-describedby=\"gfield_description_6_46\"    aria-invalid=\"false\"   \/><\/div><div class='gfield_description' id='gfield_description_6_46'>*Only Required if Participant is Under 18<\/div><\/div><fieldset id=\"field_6_26\" class=\"gfield gfield--type-signature gfield--input-type-signature gfield--width-half gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Signature of Participant- Hold Harmless, Indemnity and Release<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class=\"ginput_container ginput_container_signature\"><input type='hidden' value='' name='input_26' id='input_6_26_signature_filename'\/><div class='gfield_signature_ui_container gform-theme__no-reset--children' ><div id='input_6_26_Container' class='gfield_signature_container' style='height:180px; width:300px; ' ><canvas id=\"input_6_26\" width=\"300\" height=\"180\" style=\"border-style: Dashed; border-width: 2px; border-color: #DDDDDD; background-color:#FFFFFF; cursor: url(https:\/\/uwm.edu\/publichealth\/wp-content\/plugins\/gravityformssignature\/assets\/img\/pen.cur), pointer;\" tabindex=\"0\" aria-label=\"Signature pad\" ><\/canvas><\/div><div id='input_6_26_toolbar' style='margin:5px 0;position:relative;height:20px;width:300px;max-width:100%;'><img id='input_6_26_resetbutton' src='data:image\/png;base64,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' style='cursor:pointer;float:right;height:24px;width:24px;border:0px solid transparent' alt='Clear Signature' role='button' tabindex='0' aria-label='Clear Signature' \/><\/div><input type='hidden' id='input_6_26_data' name='input_6_26_data' value=''><\/div><\/div><\/fieldset><fieldset id=\"field_6_27\" class=\"gfield gfield--type-signature gfield--input-type-signature gfield--width-half field_sublabel_below gfield--has-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Signature of Parent or Guardian (If Participant is under 18)<\/legend><div class=\"ginput_container ginput_container_signature\"><input type='hidden' value='' name='input_27' id='input_6_27_signature_filename'\/><div class='gfield_signature_ui_container gform-theme__no-reset--children' ><div id='input_6_27_Container' class='gfield_signature_container' style='height:180px; width:300px; ' ><canvas id=\"input_6_27\" width=\"300\" height=\"180\" style=\"border-style: Dashed; border-width: 2px; border-color: #DDDDDD; background-color:#FFFFFF; cursor: url(https:\/\/uwm.edu\/publichealth\/wp-content\/plugins\/gravityformssignature\/assets\/img\/pen.cur), pointer;\" tabindex=\"0\" aria-label=\"Signature pad\" aria-describedby=\"gfield_description_6_27\"><\/canvas><\/div><div id='input_6_27_toolbar' style='margin:5px 0;position:relative;height:20px;width:300px;max-width:100%;'><img id='input_6_27_resetbutton' src='data:image\/png;base64,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' style='cursor:pointer;float:right;height:24px;width:24px;border:0px solid transparent' alt='Clear Signature' role='button' tabindex='0' aria-label='Clear Signature' \/><\/div><input type='hidden' id='input_6_27_data' name='input_6_27_data' value=''><\/div><\/div><div class='gfield_description' id='gfield_description_6_27'>*Only Required if Participant is Under 18<\/div><\/fieldset><div id=\"field_6_28\" class=\"gfield gfield--type-date gfield--input-type-date gfield--input-type-datepicker gfield--datepicker-no-icon gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_6_28'>Date<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_date'>\n                            <input name='input_28' id='input_6_28' type='text' value='' 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