BODY-Series PAR-Q & Fitness Waiver
Please complete this form before attending any class or group personal training session.
Participant Details
Full Name
*
First Name
Middle Name
Last Name
Date of Birth
*
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Email Address
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
PAR-Q Health Questionnaire
Please answer the following questions honestly. If you answer YES to any question, we recommend seeking medical advice before participating.
Has a doctor ever said you have a heart condition and you should only do physical activity recommended by a doctor?
*
Yes
No
Do you have pain in your chest during physical activity?
*
Yes
No
Have you had chest pain in the past month when not exercising?
*
Yes
No
Do you lose balance because of dizziness, or have you ever lost consciousness?
*
Yes
No
Do you have a bone or joint problem that could be worsened by exercise?
*
Yes
No
Are you currently receiving treatment for a medical condition?
*
Yes
No
Are you taking any medication that may affect your ability to exercise?
*
Yes
No
⚠️ You have indicated a potential health risk. Please seek medical clearance before participating in any BODY-Series sessions.
Informed Consent & Waiver
Please read and confirm the following statements.
Participation in fitness classes and group personal training involves physical activity and carries a risk of injury.
*
I confirm
I am physically fit and able to participate in exercise.
*
I confirm
I will take responsibility for monitoring my own physical condition during training.
*
I confirm
I will inform the coach of any pain, discomfort, or medical concerns immediately.
*
I confirm
I understand that I participate at my own risk.
*
I confirm
I release The Bodyshop Fitness Centre, its owners, coaches, and staff from liability for injury, loss, or damage sustained during participation.
*
I confirm
All information I have provided is accurate.
*
I confirm
Emergency Contact
Emergency Contact Name
*
First Name
Middle Name
Last Name
Relationship
*
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Declaration & Signature
I have read, understood, and agree to the above terms
*
Agree
E-Signature
*
Date
*
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Submit & Confirm
Submit & Confirm
Should be Empty: