Lifestyle Boom: Group Fitness and Pilates Informed Consent
1. PURPOSE AND EXPLANATION OF CLASS
The purpose of the group fitness and group Pilates class is to improve aerobic capacity and/or muscular strength and endurance and/or flexibility in addition to general body awareness. Classes are taught by Exercise and Sport Science Australia (ESSA) Accredited Exercise Physiologists. I have completed the Physical Activity Readiness Questionnaire (PAR-Q) truthfully and to the best of my knowledge and contacted my physician for clearance to exercise if recommended by the PAR-Q. I understand that I can stop the exercise session at any time if I am experiencing any symptoms of fatigue or discomfort or feel at risk of injury. I also understand that during my performance of any exercise during an exercise session physical touching and positioning of my body may be necessary to assess my muscular and bodily reactions to specific exercises, as well as to ensure that I am using proper technique and body alignment. I expressly consent to the physical contact by the instructors for the stated reasons above.
2. ATTENDANT RISKS AND DISCOMFORTS
I understand that participating in exercise can in some cases cause adverse effects including, but not limited to, abnormal blood pressure, fainting, dizziness, disorders of heart rhythm, and in very rare instances heart attack, stroke, or even death. I further understand and I have been informed that there exists the risk of bodily injury including, but not limited to, injuries to the muscles, ligaments, tendons, and joints of the body. I fully understand the risks associated with exercise, including the risk of bodily injury, heart attack, stroke or even death, but knowing these risks, it is my desire to participate.
3. RESPONSIBILITIES OF THE PARTICIPANT
You must complete the Physical Activity Readiness Questionnaire prior to taking the exercise class. It is also important to stop exercise and disclose any abnormal symptoms you may be experiencing during class such as joint pain, irregular heart rhythm, tightness or pressure in your chest, shortness of breath, light headedness, dizziness and the like. It is also important that you adhere to the recommendations of the class instructor especially with regard to the use of equipment and the choice and intensity of exercises you perform. You should not exercise if you feel in any way unable to do so in a safe manner.
4. BENEFITS TO BE EXPECTED
It is expected that you will see benefits as a result of regular and consistent participation in the class. Strength training typically results in numerous physical benefits including improved muscular strength, increased muscle mass, and general improved physical functioning in regards to physical tasks associated with work, recreation and everyday life. Aerobic conditioning typically results in health benefits including improved body composition, reduced blood pressure and reduced risk of CHD. Additional positive benefits may include changes associated with improved exercise performance including increased aerobic capacity, heart and lung function and circulation in addition to mental health benefits.
An important part of the informed consent process is providing you the opportunity to inquire about any aspect of the on-site group exercise class. Please ask the class instructor if you have any questions or concerns about the class, or email any enquires to firstname.lastname@example.org
6. USE OF MEDICAL RECORDS AND INFORMATION
Any personal information gathered in conjunction with this class will be kept confidential to the extent provided by law. No identifiable information will be released or revealed to any other party without your written consent. Information that you are asked to provide on the pre and post questionnaires as well as biometric data may be used in reports; however, your identity will be removed.
7. FREEDOM OF CONSENT
I agree to voluntarily participate in the on-site group exercise class. I understand that I am free to deny consent if I so desire now or at any point. Please Read the Following Statements Carefully and Sign in Agreement I acknowledge that I have read this form in its entirety or it has been read to me, and I understand my responsibility in the group exercise class in which I will be engaged. I accept the risks, rules and regulations set forth. Knowing these, and having had the opportunity to ask questions which have been answered to my satisfaction, I consent to participate in the group exercise class. If I am injured during the group exercise class, instructors will not be responsible for treatment. If injured, I will be responsible for seeking treatment with my own physician. An ambulance will be contacted in the event of a medical emergency. Furthermore, I, for myself and my heirs, fully release from liability and waive all legal claims against Lifestyle Boom and its instructors for injury for damage that I might incur during participation in the group exercise class.