New member sign-up with joining agreement, PAR-Q+ health screening with liability waiver, group class registration, day pass and guest visit form, plus member feedback and cancellation request — for boutique studios running CrossFit, yoga, pilates, HIIT, and small-group strength classes
Get started with PocperThis form is required before your first workout. We use the PAR-Q+ (Physical Activity Readiness Questionnaire) to screen you for risk and ensure your coach can program safely for you. The waiver section below covers acknowledgment of the risks inherent to high-intensity exercise, weightlifting, and group classes — please read every statement carefully.
Full name:
Date of birth:
Gender:
Height:
Weight:
Email address:
Mobile number:
GP / family doctor name:
GP phone:
Tick the box only if your answer is "Yes". An unticked box is a "No".
Yes — my doctor has said I have a heart condition or recommended only medically supervised activity.
Yes — I experience chest pain, dizziness, or loss of consciousness during physical activity.
Yes — I have fainted or lost consciousness during exercise in the last 12 months.
Yes — I have a bone, joint, or soft-tissue problem that is made worse by physical activity.
Yes — I am currently taking medication for blood pressure or a heart condition.
Yes — I have another medical reason my doctor has advised against unsupervised exercise.
Yes — I am pregnant, or have given birth in the last 6 weeks.
Tick anything that applies to you ("Yes" semantics).
Diabetes (Type 1 or Type 2)
Asthma or other respiratory condition
High or low blood pressure
Cardiovascular disease (heart attack, stroke, arrhythmia)
Epilepsy / seizure disorder
Recent surgery within last 6 months
Active musculoskeletal injury (back, knee, shoulder, etc.)
Other condition we should know about
Please provide details for any 'Yes' answer above (condition, treatment, restrictions):
Current medications:
Allergies (food, environmental, latex, etc.):
Recent injuries (last 12 months):
Tick all that apply to your current activity level:
Sedentary (less than 1 session/week)
Recreational (1–2 sessions/week)
Active (3–4 sessions/week)
Highly active (5+ sessions/week)
Returning after a break of 6+ months
Recovering from injury / rehab
Briefly describe your training experience and any relevant athletic background:
Participation in high-intensity training, weightlifting, gymnastics movements, and group classes carries inherent risks including cardiovascular events, musculoskeletal injury, and aggravation of pre-existing conditions. By signing below, you accept these risks knowingly and voluntarily. Please read each statement and tick to acknowledge.
I have answered the questions above truthfully and completely.
I understand that exercise of this nature carries inherent risk of injury and, in rare cases, serious harm.
If I answered "Yes" to any PAR-Q+ question, I will obtain medical clearance before participation.
I agree to inform my coach immediately of any pain, dizziness, or change in condition during a session.
I release the studio, its owners, coaches, and contractors from liability for injury arising from participation, except in cases of gross negligence.
I authorise the studio to administer reasonable first aid and to call emergency services on my behalf if needed.
I authorise the use of my anonymised performance data for class programming and progress tracking.
I confirm I am 18+ or have a parent/guardian co-signing where required.
Doctor / clinic name:
Doctor's phone:
Clearance issued on:
Restrictions / accommodations recommended:
Participant signature (full name):
Date:
Parent/Guardian signature (if under 18):
Date:
Coach / staff witness:
Date:
Thank you for completing the health screening. Please retain a copy for your records — your coach will contact you if any clarification is needed.
The Health Screening (PAR-Q+) & Liability Waiver template is a ready-to-use form from Pocper's Boutique Fitness Studio pack. Customize the fields to match your workflow, then share a link so clients can complete it and upload documents in real time.