Salsa City Studio Agreement and Release of Liability

*Please note that this Release/Waiver covers liability at any and all locations where Salsa City Studio (Synergy Fitness, LLC) classes are held.

I the undersigned, hereby expressly and affirmatively state that I wish to participate in the Synergy Fitness exercise class. I realize that my participation in this activity involves risks of injury, including but not limited to muscle strain, joint sprains, broken bones, slips, trips, falls, heart attack, stroke and even the possibility of death. I also recognize that there are many other risks of injury including serious disabling injuries, which may arise due to may participation in the activity, and that it is notpossible to specifically list each and every possible injury risk. However, knowing the material risks and appreciating, knowing risks of injury, all other possible risks of injury, and even the risk of death, which could occur by reason of my participation. I subjectively understand the risk of my participation in this activity, and knowing and appreciating these risks voluntarily choose to participate, assuming all risks of injury or even death due to my I do hereby waive, release, and forever discharge all employees, representatives, and all others from any and all responsibilities or liability or damages resulting from my participation in this activity.

Physical Activity Readiness Questionnaire

PARQ (revised 2002) PARQ &You (A questionnaire for people aged 15 to 69) regular physical activity is fun and healthy, and increasingly more people are starting to become more active every day.  Being more active is very safe for most people. However, some people should check with their doctor before they start becoming

much more physically active. If you are planning to become much more physically active than you are now, start by answering the 7 questions below. If you are between the ages 15-69, the PARQ will tell you if you should check widi your doctor before you start. If you are over 69 years of age, and you are not used to being very active, check with your doctor before you start. Common sense is your best guide when you answer these questions. Please read these questions carefully and answer each one honestly:

Select YES or NO

If you answered Yes to one or more of the questions above  OR if your doctor is UNAWARE of your concerns.  Delay becoming more active.

Talk with your doctor by phone or in person BEFORE you start becoming more physically active or BEFORE you have a fitness appraisal. Tell your doctor about the PAR-Q and which questions you answered YES. Find out which community programs are safe and helpful for you.  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 that are safe for you. Talk with your doctor about the kind of activities you wish to participate in and follow his/her advice.

If you answered No honestly to all PAZ-Q questions,  you can be reasonably sure that  you can participate.

Start becoming more physically active. Begin slowly and build up gradually. This is the safest and easiest way  to go. Take part in a fitness appraisal.This is an excellent way to determine your basic fitness so that you can plan the best way for you to live actively. It is also highly recommended that you have your blood pressure  evaluated. If your reading is over 144/94, talk with your doctor before you start becoming more physically  active.

If you are not feeling well because of temporary illness such as a cold or a fever - wait until you feel better. 

If you are or maybe pregnant - talk to your doctor before you start becoming more active.

Please note: if your health changes such that you would answer the above questions with a Yes

tell your fitness or health professional immediately. Ask whether you should change your physical activity plan.

Informed use of the PARQ.

The Canadian Society for Exercise & Physiology, Health Canada, and their agents assume no liability for persons who undertake physical activity, and if in doubt after completing this questionnaire, consult your doctor regarding your physical activity.

I have read, understood and completed this questionnaire. Any questions I had were answered to my full satisfaction.

This physical activity clearance is valid for a maximum of 12 months from the date it is completed and becomes invalid if your condition changes so that you would answer YES to any of the 7 questions.

Canadian Society for Exercise Physiology.