If you are between the ages of 15 and 69, the par-q will tell you if you should check with your doctor before you significantly change your physical activity patterns. If you are over 69 years of age and are not used to being very active, check with your doctor.

Common sense is your best guide when answering these questions. Please read carefully and answer each one honestly: Circle YES or NO.

1. Has your doctor ever said that you have a heart condition
and that you should only do physical activity recommended by a doctor? Yes No
2. Do you feel pain in your chest when you do physical activity? Yes No
3. In the past month, have you had chest pain when you were
not doing physical activity? Yes No
4. Do you lose your balance because of dizziness or do
you ever lose consciousness? Yes No
5. Do you have a bone or joint problem (for example, back, knee or hip)
that could be made worse by a change in your physical activity? Yes No
6. Is your doctor currently prescribing drugs (for example, water pills)
for your blood pressure or heart condition? Yes No
7. Do you know of any other reason why you should not
do physical activity? Yes No
If yes please comment:________________________________________________

___________________________________________________________________
YES to one or more questions: You should consult with your doctor to clarify that it is safe for you to become physically active at this current time and in your current state of health.

NO to all of these questions: You can be reasonably sure that it is safe for you to participate in physical activity, gradually building up from your current ability level. A full fitness appraisal can help to determine your fitness level.

I agree to photographs and videos of myself being used in promotional materials Y/N

“I have read, understood and accurately completed this questionnaire. I confirm that I am voluntarily engaging in an acceptable level of exercise and my participation involves a risk of injury.”

Clients Name: Trainers Name:
Signature: Signature:
Date: Date:

Having answered YES to one of the above I have sought medical advice and my GP has agreed that I may exercise.

Signature: Date:

CrossFit Lutterworth is strongly committed to the security and protection of members’ personal information and we do our utmost at all times to ensure privacy. We take the security and privacy of our customers very seriously. We strive to conform with the UK and European Data Protection laws. We do not share any information with third parties, nor do we collect or retain any information other than that necessary for us to provide our services to you.

We use members’ personal information only as necessary for us to provide our services to you. We do not share any information with unrelated third parties nor do we collect or retain any information other than is required for the provision of our products or services. Information collected during the online registration process is stored securely. Information collected will be securely destroyed if it is no longer required by CrossFit Lutterworth. Members may request details of personal information, which we hold under the Data Protection Act/forthcoming General Data Protection Regulation. A small fee will be payable. Copies of the information can be obtained by writing to us at info@crossfitlutterworth.com. If you believe that any information we are holding on you is incorrect or incomplete, please write to or email us as soon as possible, at the above address. We will promptly correct any information found to be incorrect. We request all members check their details for accuracy annually and make any necessary changes. This includes redoing our waiver if any information has been changed on Team Up. We will email reminders for this. Please note in order to receive emails from us, you need to ‘opt in’ and complete an email verification to show your consent in order for us to comply with legal requirements. We require this to allow us to communicate with members effectively.
Please note that CrossFit Lutterworth does provide links to other sites (notably our sister-shops – Reebok, Thorn Performance etc; once you have used these links to leave our site, you should note that we do not have any control over that other website. Therefore, we cannot be responsible for the protection and privacy of any information which you provide whilst visiting such sites and such sites are not governed by this statement. You should exercise caution and look at the privacy statement applicable to the website in question.
Our website, particularly the blog, and associated Facebook, Twitter and Instagram accounts, may contain links to enable you to visit other websites of interest easily. However, once you have used these links to leave our site, you should note that we do not have any control over that other website. CrossFit Lutterworth cannot be responsible for the protection and privacy of any information which you provide whilst visiting such sites and such sites are not governed by this policy statement. You should exercise caution and look at the privacy policy applicable to the website in question. We have no responsibility for the content of the linked website(s).
Where we engage third party contractors (e.g. coaches, presenters) to perform services for us, those third party contractors may be required to handle your personal information. Under these circumstances, those third party contractors must safeguard this information and must only use it for the purposes for which it was supplied, although we are not responsible for ensuring this. Other than the above, we will not disclose your personal information without your consent unless disclosure is either necessary to prevent a threat to life or health, authorised or required by law, reasonably necessary to enforce the law or necessary to investigate a suspected unlawful activity.
CrossFit Lutteworth makes use of third party software to manage bookings and membership, provided Team Up. Team Up has their own privacy and data security policy with regard to client information. You can access this information on their website.
Personal information collected by CrossFit Lutterworth and our website info@crossfitlutterworth.com is stored in secure operating environments that are not available to the public. We will protect your personal information no matter where we process or store your data.
Changes to our Policy: From time to time, it may be necessary for us to review and revise this Policy. We reserve the right to change our Policy at any time and should this occur, the amendment will be posted on our website and will be effective immediately.
CCTV is in operation at CrossFit Lutterworth. Signs are displayed to make all visitors and members aware of this. There is one sign on the front gate, one sign on the roller shutter door, another by the main entrance, and one in the main gym. There are currently four cameras in operation, one monitoring the car park and the other monitoring the gym floor and reception.
The Company Director has shared this policy with all staff members so everyone is aware our requirements under the Data Protection Act/forthcoming General Data Protection Regulation and other relevant legislation. All staff have been made aware how to handle personal data, in this case, not to share with anyone at any time unless required to by Law, and that it is a criminal offence to do so.
There are various contacts available on CrossFit Lutteworth ’s website, any of which can be used as an access point to information and complaints in relation to our CCTV.
We have utilised Appendix 2 from the CCTV Code of Practice (October 2014) to ensure our compliance with CCTV requirements. This can be found at the end of this policy, entitled “CCTV checklist”.
Our business Terms and Conditions are available on our website which outlines how we use personal information. This is freely available information so anyone visiting our website can access it.
Any requests for personal information go straight to the Company Director for action.
We annually request members update their information. Any old members that have left and there is no chance of them returning are deactivated on Team Up‘s system. This third party, external system is only accessible by staff using specific details and is not freely available.
CLUB DATA PROTECTION OFFICER: …. Katie Dunk………………………..

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CCTV Checklist:

• Named individual responsible for the operation of the system: Katie Dunk

• The problem we are trying to address has been clearly defined and installing cameras identified as the best solution. This decision is reviewed on a regular basis:
o The CCTV is for capturing thefts and any incidents, and to back up staff if needed when working alone with a client. Reviewed annually for effectiveness.

• A system has been chosen which produces clear images which law enforcement bodies (i.e.the police) can use to identify crime. These can easily be taken from the system when required.

• Cameras have been sighted so that they provide clear images and cover the biggest areas possible. They have been positioned to avoid capturing the images of people not visiting the premises.

• As mentioned in the policy text, there are visible signs showing that CCTV is in operation.

• Images are securely stored on the CCTV server and only authorised staff have access to them. They will not be shared with any third party with the exception of law enforcement bodies.

• The recorded images are wiped monthly. This is automatically actioned by the system. From past events this has shown to just be enough for incidents to come to light (e.g. thefts). Any shorter and these incidents risk being missed.

• The potential impact on individuals’ privacy has been identified when taking into account the use of the system. Cameras are sited to film only that which would be in plain sight, and the monitor location has also been chosen bearing this in mind.

• CrossFit Lutterworth knows how to respond to individuals making requests for copies of their own images, and to seek advice from the Information Commissioner as soon as such a request is made. Firstly an offer for them to come and view the footage would be made, then a copy supplied if still requested. A third party company (by means of a secrecy contract) would be used to blur our the faces of others if deemed necessary. Staff have been made aware it is a criminal offence to misuse CCTV footage

• Regular checks are carried out to ensure the system is working properly and produces high quality images. Spiderwebs are cleaned off the external camera monthly, or more frequently if required and a signed record of this is kept. Viewing monitor is switched on at the start of each day to ensure the cameras are online and working properly. The date and time stamp is checked at least twice a year (accounting for daylight savings’ time) and the system is reviewed annually for effectiveness.