Event Intake Form

Please take a moment to fill out our online intake form

Full Name*

E-mail*

Do you have a fever?

Yes No

Have you been experiencing any COVID-19 like symptoms?

Yes No

Have you traveled or have had close content with anyone who has traveled in the last 14 days?

Yes No

You can opt to receive emails to keep you informed of new content, announcements, and upcoming event updates

I would like email notifications of new content, announcements, and event updates. (Optional)

Release of Liability

By checking the box here and clicking ‘Submit Intake Form’; below, and in consideration for being present and participating in a WWRC workout (West Way Run Crew under revibe TO Inc) at our choice of site.., you agree to hereby release, hold harmless and discharge the Owners, Revibe TO Inc.., and Revibe TO Inc.s’ and respective corporate affiliates and subsidiaries (including but not limited to Revibe TO Inc.), their respective directors, officers, shareholders, partners, employees, licensed therapists, and any other employee or subcontractor within the Revibe TO Inc. group of companies (collectively, the “Released Persons’ and individually a “Released Person”) from any responsibility or liability due to your participation in Medical Services. Any legal action involving any of the Released Persons shall be governed by and construed in accordance with the laws of Ontario.

Social Media Release

Due to the nature of the activities of the event, you understand that WWRC and Revibe TO Inc. may post pictures or videos pertaining to you on a social media outlet such as, but not limited to, Instagram, YouTube and/or Facebook. I understand that Revibe TO Inc.. uses social media for marketing and as an educational tool. I understand that when posted online, this information is in the public domain.

nagging pain?

Start your recovery process, strengthen mobility, and prevent future injury.

Event Intake Form

Please take a moment to fill out our online intake form

nagging pain?

stay connected

About Us

Services

Get Help

Learn

Be You, Again

Book your next wellness experience in