Welcome to Betty's Box BC!

We're thrilled that you've chosen to drop in with us! We’re a supportive community of strong, empowered women committed to health, strength, and personal growth.

Please note this form is for guests trained in Crossfit or functional fitness, dropping in as a visitor of our gym. If you are interested in joining Betty's Box BC, please click here.

Before you begin your first workout, we’d love to learn a little about you to ensure your safety and help make sure you have a great experience! When you finish, please sign and submit the waiver.

We have a $20 drop-in fee, you can pay cash in person or via venmo here.

Let's get started! 💖

First name

Last name

Phone

Mailing Address

Birthday

Month

Day

Year

How did you find us?

Regular physical activity is a fantastic way to boost your health and well-being, and more and more people are embracing an active lifestyle every day. For most individuals, being active is perfectly safe. However, if you're just beginning a new exercise program, it may be wise to consult your doctor—especially if you have any existing health concerns.

We’re here to help you make the best decisions for your fitness journey. To get started, please answer the next seven questions. These will help determine whether it’s a good idea for you to check in with your physician before joining our workouts.

If you’re over the age of 69, we strongly recommend consulting your doctor before beginning any rigorous exercise program.

Has your doctor ever said that you have a heart condition and recommend only medically supervised physical activity?

Yes

Do you frequently have pains in your chest when you perform physical activity?

Yes

Have you had a stroke?

Yes

Do you lose balance due to dizziness or do you ever lose consciousness?

Yes

Do you have a bone, joint, or any other health problem that causes you pain or limitations that must be addressed when developing an exercise program? (e.g. diabetes, osteoporosis, high blood pressure, epilepsy, respiratory ailments, back problems, etc.)

Yes

Are you pregnant of have you recently given birth?

Yes

Do you have asthma or exercise induced asthma?

Yes

Do you have low blood pressure (hypoglycemia)?

Yes

Do you have diabetes?

Yes

Have you had surgery recently?

Yes

If you answered yes to any of the previous questions, please share any information that might be helpful if you were to have a medical event.

Emergency Contact Name

Emergency Contact Phone Number

Payment Type

Cash in person

Venmo (linked above)

Betty's Box BC assumes no responsibility for persons who undertake physical activity, and if in doubt after completing the questionnaire, consult your doctor prior to physical activity. I have read, understood, and completed this questionnaire.

I accept