Health and safety declaration — Supervised range practice

This health declaration is intended solely for Koach Hatzafon's Training and Qualifications Division. It is not the official health declaration required under the Firearms Licensing Division's training regulations and procedures, and does not replace that declaration or a physician's approval where required.

This declaration supports safe participation in training run by Koach Hatzafon's Training and Qualifications Division. It is not a medical assessment, a fitness certificate or a replacement for official forms or a physician's approval required for firearms licensing. 1. To the best of my knowledge, no medical instruction prohibits my participation in the planned activity. If I have a limitation, a change in health or any doubt about suitability, I will consult a physician and notify the staff before participating. 2. I will privately inform the staff of functional limitations relevant to safety or any adjustment I need. I do not need to list diagnoses, medications or my full medical history here. 3. I will not participate under the influence of alcohol, drugs or any substance or medication that may impair alertness, judgment or functioning. If uncertain about medication, I will consult my physician or pharmacist; I will not change medical treatment for training. 4. If I experience unusual pain, dizziness, weakness, shortness of breath or difficulty continuing safely, I will stop the activity and immediately inform the instructor. 5. I will bring the documents and authorizations required for this training, follow the safety briefing and use protective equipment required by the range and staff. 6. I will notify the staff of any relevant change before training. Completing this declaration does not automatically approve participation. Where medical clarification is needed, it must be obtained from a physician before activity.

I confirm that I have read and understood this declaration, that the information I provided is accurate to the best of my knowledge and that I will notify the staff of any change. Each participant acknowledges individually; nobody may sign for another participant.

This declaration also applies to activity performed at my own pace. I will arrange breaks with the staff and will not continue if a health or functional difficulty develops.