Pilates Realm

Before your first session

Ruqayyah K-J · STOTT PILATES® certified instructor · Toronto, Ontario

There are two forms to complete before your first session. Together they take about ten minutes. The first is a health questionnaire used worldwide by exercise and medical professionals. The second is an agreement about risk, which you sign on paper in person.

Form 1 — PAR-Q+ health screening

The Physical Activity Readiness Questionnaire for Everyone (PAR-Q+) is the international standard for pre-participation screening. It was developed through the evidence-based AGREE process by the PAR-Q+ Collaboration, with the Canadian Society for Exercise Physiology, and it is the form your doctor or physiotherapist will recognise if you ever need to show them one.

Important

The PAR-Q+ must be used whole and unaltered — that is a condition of its use, and it is why it is not reproduced as a web form here. Download and print the current official version:

Get the official PAR-Q+ from eparmedx.com

What happens with your answers

If you answer NO to all seven questions on page one, you may become more physically active and complete the participant declaration.
If you answer YES to any of them, complete pages two and three. Depending on those answers you may be asked to complete the ePARmed-X+ at eparmedx.com, or to speak to your doctor or a qualified exercise professional first.
Clearance is valid for a maximum of twelve months and becomes invalid if your condition changes. Tell Ruqayyah if anything changes — it changes what she plans for you, not whether you are welcome.
Ruqayyah keeps your completed form confidentially, as her records, in line with applicable law.

Form 2 — Informed consent, assumption of risk and release

Please read this section carefully before signing. It affects your legal rights, including your right to bring a claim for injury.

1. What the activity involves

Pilates instruction on the mat and on apparatus, which may include a reformer and other spring-loaded equipment, delivered one to one or in a duet, in a studio, at an address you provide, or live online. Sessions involve physical exertion, stretching, resistance from springs and straps, changes of position, and instruction that may include hands-on cueing. You may decline hands-on cueing at any time.

2. Risks you are accepting

Physical activity carries risk that cannot be removed, however carefully a session is run. These risks include but are not limited to:

muscle strains, sprains, joint injury, back or neck injury;
injury from spring-loaded apparatus, straps, cords or moving carriages, including from equipment failure or incorrect setting;
slips, trips and falls, and contact with equipment or the floor;
aggravation of an existing or unknown condition or injury;
fainting, dizziness, abnormal heartbeat, and in rare cases heart attack or stroke;
where a session takes place at your own address, risks arising from that space, its floor surface and its furnishings;
where a session takes place online, the absence of hands-on correction and of anyone physically present to assist you.

3. What you are confirming

You have completed the PAR-Q+ honestly and disclosed anything relevant, and you will tell Ruqayyah if your health changes.
You are participating voluntarily, and you believe yourself fit to take part.
You will follow instructions, work within your own limits, and stop and say so if something hurts.
You understand that Ruqayyah is a Pilates instructor. She is not a doctor, physiotherapist or dietitian, and nothing in a session is medical advice, diagnosis or treatment.

4. Assumption of risk and release of liability

In consideration of being permitted to take part, I freely accept and fully assume all risks of taking part in Pilates instruction provided by Ruqayyah K-J, trading as Pilates Realm, including the risks listed above.

I release, waive and forever discharge Ruqayyah K-J and Pilates Realm, and their instructors, agents and assistants, from all claims, demands, actions and costs of any kind arising from my participation, from the use of any equipment, or from being present at any location where a session takes place, including any such claim arising from their negligence.

I agree that this release binds me, my heirs and my legal representatives, that it is governed by the laws of the Province of Ontario, and that any dispute will be heard in the courts of Ontario. If any part of it is found unenforceable, the remainder continues to apply.

5. Your acknowledgement

I confirm that I have read this entire document and understand it, that it was given to me before I took part, that I had the opportunity to ask questions, and that I am signing it freely. I understand that I am giving up substantial legal rights, including the right to sue.

Participant name (print)
Date
Participant signature
Witness signature
Emergency contact — name and phone
Parent or guardian signature (required if under 18)
Date

Notes

Why on paper. A signed paper form is stronger than a tick-box online. In Ontario a release of this kind is generally a complete defence where it is clear, where it says plainly that it covers negligence, and where it was genuinely brought to the signer's attention before they took part (Schnarr v. Blue Mountain Resorts and Woodhouse v. Snow Valley, 2018 ONCA 313). Giving it to the client to read in advance, and letting them ask questions, is the part that does the work.

Standing practice. Keep the signed forms. Re-run the PAR-Q+ every twelve months, or sooner if someone's health changes. Anyone under 18 needs a parent or guardian signature.

This is a standard-form document, not legal advice. It is assembled from the components Ontario courts look for and is the shape used across the fitness industry. Conversion Forge is not a law firm. Before you rely on it, have it read once by your insurer or a lawyer — most liability insurers will review a waiver for a client at no charge, and their sign-off also protects your coverage.

PAR-Q+ citation. Warburton DER, Jamnik VK, Bredin SSD and Gledhill N, on behalf of the PAR-Q+ Collaboration. Health & Fitness Journal of Canada 4(2):3–23, 2011. Copyright © PAR-Q+ Collaboration. Used by reference, unaltered, as its terms require.

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