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Back Beach Fitness Limited - PAR-Q

Back Beach Fitness: Physical Activity Readiness Questionnaire (PAR-Q)

This questionnaire is designed to help determine whether it is safe for you to participate in physical activity and exercise at Back Beach Fitness. Please answer each question honestly. If you answer YES to one or more questions, you may be asked to seek medical clearance before participating.

Please note if you If you are not feeling well because of a temporary illness such a cold or a fever, please wait until you feel better to train, or if you are or may be pregnant please talk to your doctor before you start becoming more active.

Declaration & Informed Consent

I declare that, to the best of my knowledge, the information I have provided is complete and accurate. I understand that it is my responsibility to inform Back Beach Fitness of any changes to my health status. I acknowledge that participating in physical activity and exercise involves risks, and I voluntarily choose to participate.

I understand that if I answered YES to one or more questions, I may be required to obtain written medical clearance from a qualified healthcare professional before participating in training or classes.

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Date

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

2. Do you feel pain in your chest when you do physical activity?

Yes

3. In the past month, have you had chest pain when you were not doing physical activity?

Yes

4. Do you lose your balance because of dizziness or do you ever lose consciousness?

Yes

5. Do you have a bone, joint, or soft tissue problem (for example, back, knee, hip, shoulder) that could be made worse by a change in your physical activity?

Yes

6. Has your doctor ever said that you have high blood pressure?

Yes

7. Are you currently taking any prescribed medication for a heart condition, blood pressure, or any other medical condition that may affect exercise?

Yes

8. Do you have diabetes or any other thyroid condition?

Yes

9. Do you know of any other reason why you should not take part in physical activity?

Yes

I accept the above terms

Back Beach Fitness Limited - Media consent (over 18)

We may take photos or video of you and would like to use them for promotional purposes. They may appear in on our website, on printed media (such as leaflets or posters) and on our social media channels.

The video or image(s) could be used at any time, normally within a five-year period from the date of consent. However, once a publication is printed it will likely remain in use for a number of years.

Selecting “No” means you consent to images and videos being used as described.

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I am over 18 years old

Do you object to Back Beach Fitness Ltd storing and sharing image(s) and video(s) of you in the ways described in this consent form?

Yes

I have read and understood the conditions of use.