Take Command! Program Application

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Personal story

What would be the most significant change you’d like to see in your life after completing this program?

Video Submission Guidelines:
Record a 2-3 minute video sharing your story. Be honest and authentic–tell us why this program is the right fit for you. Why is improving your health important to you at this point in your life? What do you hope to gain from this program?

Please upload your video to this google drive folder: Submit your Take Command! Video Here

First Name *

Last Name *

What is your affiliation?

Other - please explain

Gender *

Shirt Size

XXL

Email *

Birthday *

Phone 1 *

Address Line 1

Address Line 2

City

State/Province

Zip/Postal Code

Country

Emergency Contact Name and Phone Number

How did you hear about us? *

Please explain

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Do you understand and agree to actively participate in all scheduled meetings, events, and activities as outlined in the program schedule? *

Yes, I understand and accept

I understand that my full participation is essential–not only for my own success but for the growth and momentum of my cohort. *

I Agree

I am fully committed to this program and have made it a priority in my life. I recognize that transformation requires consistency, effort, and engagement. *

I Agree

Do you foresee any potential conflicts that could interfere with your full participation? *

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Participant Acknowledgment & Waiver - I understand that the Take Command! Program may include physical activity, exercise instruction, wellness education, nutritional guidance, and accountability coaching. I acknowledge that participation in any physical activity carries inherent risks, including but not limited to injury, illness, or other health complications. I certify that I am physically able to participate in this program and understand that it is my responsibility to consult with a physician or qualified healthcare provider before beginning any fitness or wellness program, especially if I have any medical conditions or concerns. By participating in the Take Command! Program, I voluntarily assume all risks associated with participation and release, waive, and hold harmless Health4Heroes, its staff, volunteers, partners, coaches, and affiliates from any and all liability, claims, demands, damages, or causes of action arising from participation in the program. I understand that I may stop participation at any time if I experience pain, discomfort, dizziness, or other health concerns. By selecting “I Agree,” I acknowledge that I have read, understood, and voluntarily agree to the terms outlined above.

I agree

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Take Command! Program Application