I, the undersigned, hereby state that I wish to participate any exercise within StrongHer. I realise that my participation in these activities involves potential risk of injury, including but not limited to bodily injury, heart attack, stroke, or even death. I also recognise there are other risks associated with exercise and that it is not possible to list every one. I know and understand the risks of exercise, understand that injuries are a possibility, and I hereby assume all risks of injury which could occur by reason of my participation in this fitness class. I hereby state that I am in good health and are able to take part in this activity. I take full responsibility for my own health and well being and agree that any instructions received will be used at my own risk.
Has your doctor ever said that you have a heart condition and that you should only perform physical activity recommended by a doctor?
Do you feel pain in your chest when you perform physical activity?
In the past month, have you had chest pain when you were not performing any physical activity?
Do you lose your balance because of dizziness or do you ever lose consciousness?
Do you have a bone or joint problem that could be made worse by a change in your physical activity?
Is your doctor currently prescribing any medication for your blood pressure or for a heart condition?
Do you know of any other reason why you should not engage in physical activity?
