If you answered NO to all of the questions above, you are cleared for phyiscal activity. If you answered ‘YES’ you are required to obtain a doctor's note that states you are eligible to participate in Group fitness class
Because physical exercise can be strenuous and subject to risk of injury, we urge you to obtain a physical examination from a doctor before using any exercise equipment or participating in any exercise activity.
You agree that by participating in physical exercise or training activities, you do so entirely at your own risk.
If you are less than the legal age required for consent or require the assent of a care provider, your parent, gaurdian or care provider must also sign this form.
I, the undersigned, have read, understood to my full satisfaction and completed this questionnaire. I acknowledge that this physical activity clearance is valid for a maximum of 12 months from the date it is completed and becomes invalid if my condition changes. I also acknowledge that Squamish Valley Recreation may retain a copy of this form for its records, In these instances, it will maintain the confidentiality of the same, complying with applicale law.