ParQ (Physical Activity Readiness Questionnaire) & Informed Consent

๐Ÿƒ๐Ÿพโ€โ™‚๏ธIF YOU ARE NEW TO MY CLASSES, YOU WILL NEED TO FILL IN THE QUESTIONNAIRE BEFORE PARTICIPATING IN THE CLASS ๐Ÿƒ๐Ÿผโ€โ™€๏ธ

IF YOU HAVE PREVIOUSLY FILLED IN THE QUESTIONNAIRE, THERE'S NO NEED TO DO SO AGAIN.

Name *
Name
Address *
Address
D.O.B: *
D.O.B:
General Medical History
Have you ever experienced any of the following, past or present, when resting or when active? *
Please tick where appropriate.
Please give details here:
If so, please give details:
If so, please give details:
If so, please give details:
Pregnancy History
If so how many weeks/due date?
Are you suffering with any pregnancy related muscular skeletal problems at the moment?
If so, what.
Do you have any children already?
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Please see our privacy page for details on how I use your data. I'll treat it very carefully, never share it with anyone and I promise to only send useful, informative info by email (and not bombard you!)
Informed consent
Every precaution will be taken to ensure you are safe during participation in the class. You are aware the nature of the classes and any risks involved. You must stop if you feel signs of fatigue, strain or any discomfort. There exists the possibility of certain dangers when exercising. They include abnormal blood pressure, fainting, irregular, fast or slow heart rhythm, and in rare instance, heart attack, stroke or death. Please be aware the following are warning signs to stop exercising when you are pregnant: vaginal bleeding, being out of breath, dizziness, headache, chest pain, calf pain or swelling, amniotic fluid leakage. Whilst every care is taken, it is impossible to predict the bodyโ€™s exact response to exercise. You agree that you are physically capable of participating in the sessions and accept full and complete responsibility for your own participation in the class. Your Instructor shall not be liable to you for any indirect or consequential loss or damage including loss of earnings arising out of your participation in classes. You are aware you must let your Instructor know if there is any change in your health. The Woodland Workout is an outdoor fitness class whatever the weather. Please wear appropriate clothing whether itโ€™s wet, cold or hot. You will understand that the class takes place on a natural terrain where there are are hazards such as tree roots, twigs, leaves etc so please take your own precautions and watch where you are treading when we jog or run especially. You accept full liability for any injury that may arise when you are on the property of Victoria Corbett or within the class itself. For pregnant participants: Your midwife, GP or Consultant is aware you are participating in this exercise class. I agree to the terms and conditions stated above
Signed *
Signed
Please enter your full name here to signify that you have read and completed this form in full.
Date *
Date
If you answered YES to one or more of the above questions: You must talk with your doctor before becoming much more physically active or before you have a fitness appraisal. Tell you doctor about the kinds of activities you wish to participate in and follow the doctors advice accordingly. If you answered NO to all questions: Begin slowly and build up gradually. If you are not feeling well because of a temporary illness such as a cold or fever - wait until you feel better. If you are or may be pregnant - talk to your doctor before you start to become more active.