Level 10 Fitness Waiver

Level 10 Fitness waivers are necessary to evaluate your overall health. Please fill out the form below before signing up for a class so that we can keep accurate records and meet your individual needs. This form will help us evaluate your health and provide us with the information we need. Thank you and see you at the Gym!

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Par Q New (creates new account)

Emergency Contact Information

Studio Liability Release

In checking the box below I agree that Level 10 Fitness in no way responsible for the safekeeping of my personal belongings while I attend class. I understand that classes may be physically strenuous and I voluntarily participate in them with full knowledge that there is risk of personal injury, property loss or death. I agree that neither I, my heirs, assigns or legal representatives will sue or make any other claims of any kind whatsoever against or its members for any personal injury, property damage/loss, or wrongful death, whether caused by negligence or otherwise.

Photography and Video Permission


I, undesigned, hereby give my permission to have photos and videos taken of me and for the photos and videos to be used for promotional purposes, by Level 10 Fitness. I understand that the photos and videos may be used in many different ways that may include but are not limited to media promotion, advertising, publications and social media sites.

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 seven questions in the box below. If you are between the ages of 15 and 69, the PAR-Q will tell you if you should check with 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. Common sense is your best guide when you answer these questions. Please read the questions carefully and answer each one honestly: check YES or NO.

If you answered Yes to one or more questions:

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

If you answered No to all questions:
If you answered NO honestly to all PAR-Q questions, you can be reasonably sure that you can: • start becoming much 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 much more physically active.  PLEASE NOTE: If your health changes so that you then answer YES to any of the above questions, tell your fitness or health professional. Ask whether you should change your physical activity plan. DELAY BECOMING MUCH MORE ACTIVE: • ifyouarenotfeelingwellbecauseofatemporaryillnesssuchas a cold or a fever – wait until you feel better; or • if you are or may be pregnant – talk to your doctor before you start becoming more active.