I, the undersigned, do hereby acknowledge:

  • my consent to perform a fitness evaluation the results of which will assist in determining the type and amount of physical activity most appropriate for my level of fitness;
  • my consent to perform exercise sessions (which includes cardiovascular, muscle conditioning, muscle strengthening and flexibility exercises) with the guidance of a personal trainer, in my home fitness club or any and all Active Life training facilities or studios.
  • my consent to the test and the training sessions conducted by an individual who is an approved Active Life implementer. I understand that the interpretation of results is limited to providing a comparison with percentile-based norms and information on various aspects of fitness. In addition, this information will be used for re-testing comparisons.
  • my obligation to immediately inform my trainer of any pain, discomfort, fatigue or any other symptoms that I may suffer during and immediately after any test and all training sessions.
  • my understanding that there are potential risks: i.e., episodes of transient lightheadedness, fainting, abnormal or increased blood pressure, chest discomfort, leg cramps and muscular discomfort, and that I assume willfully those risks.
  • that I have read, understood, and completed the Physical Activity Readiness Questionnaire (PAR-Q) on the reverse or attachment to this page.
  • my understanding that the best results of personal training and a conditioning programme occur over consistent training.
  • that I hereby release Active Life Conditioning Inc., its agents, officers, trainers and employees from any liability with respects to any damage or injury (including death) that I may suffer during any testing and / or any and all training sessions, all training facilities or locations.


[contact-form subject=”Active Life Conditioning Waiver” to=””]  [contact-field label=”Has your doctor ever said that you have a heart condition and recommended you only participate in specific activities?” type=”radio” required=”true” options=”YES,NO” /] [contact-field label=”Do you have chest pain brought on by physical activity?” type=”radio” required=”true” options=”YES,NO” /] [contact-field label=”Have you developed chest pain in the past month?” type=”radio” options=”YES,NO” /] [contact-field label=”Do you have a bone or joint problem that could be aggravated by the proposed physical activity?” type=”radio” options=”YES,NO” /] [contact-field label=”Is your doctor currently prescribing medication for your blood pressure or heart condition?” type=”radio” required=”true” options=”YES,NO” /] [contact-field label=”Are you aware, through your own experience or a doctor’s advice, of any other reason why you should not exercise without medical approval?” type=”radio” options=”YES,NO” /] [contact-field label=”Females only: Are you pregnant” type=”radio” options=”YES,NO” /]

YES to one or more questions?

  • Talk to your doctor before becoming physically active or before you have a fitness evaluation.
  • Tell your doctor about the Par-Q and which question(s) you answered “yes”.
  • You may be able to do any activity you want – as long as you start slowly and build up gradually. Or, you may need to restrict your activities to those, which are safe for you. Talk to your doctor and follow his/her advice.


  • If you have temporary illness, such as a fever, or are not feeling well at this time, we advise that you postpone the proposed activity.
  • If you are pregnant, you are advised to discuss the “Par-X for pregnancy” form with your physician before exercising.
  • If there are any changes in your status relative to the above questions, please bring this form to the attention of a fitness professional. You may need to make adjustments to your program.
[contact-field label=”Signed (type your name)” type=”name” required=”true” /] [contact-field label=”Dated today” type=”text” required=”true” /] [contact-field label=”Email” type=”email” required=”true” /] [/contact-form]

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