Fit Adultz/Fit Famz Physical Activity Readiness Questionnaire (PAR-Q) - Fit Kidz | Fit Adultz

Fit Adultz/Fit Famz
Physical Activity Readiness Questionnaire (PAR-Q)

Fit-Adultz/Fit-Famz Physical Activity Readiness Questionnaire (PAR-Q)

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Prior to participating in any fitness appraisal, workshop, or other exercise routine, you are required to complete this PAR-Q together with the Informed Consent Release and Waiver Form (‘ICRW’). For most people, physical activity should not pose any problem or hazard, however, potential risks, whilst not apparent at rest, may be exacerbated by an increase in levels of physical activity. The PAR- Q is designed to identify the small number of adults for whom physical activity might be inappropriate or those who should seek medical advice concerning the type of activity most suitable for them.

The ICRW contains information relating to the level of exercise you are likely to be undertaking with us and should be read in conjunction with this PAR-Q.
Please complete the questionnaire below by reading each question carefully and inserting a tick against the response that applies to you. You are wholly responsible for your answers and if you are in any doubt you must seek medical advice.
Has your doctor ever said that you have a bone or joint problem, such as arthritis, or any medical condition, surgical operation or injury that has been aggravated by exercise or might be made worse with exercise?Do you have high blood pressure?Do you have low blood pressure?Do you have Diabetes Mellitus or any other metabolic disease?Has your doctor ever said you have raised cholesterol (serum level above 6.2mmol/L)?Has your doctor ever said that you have a heart condition and that you should only do physical activity recommended by a doctor?Have you ever felt pain in your chest either at rest or when you do physical exercise?Is your doctor currently prescribing you drugs or medication?Have you ever suffered from unusual shortness of breath either at rest or with mild exertion, or suffer from any allergies, asthma or hayfever etc?Is there any history of coronary heart disease in your family?Do you often feel faint, have spells of severe dizziness or have you ever lost consciousness?Do you currently drink more than the average amount of alcohol per week (21 units for men and 14 units for women)?Do you suffer from regular headaches, dizziness, fainting or fits?Do you NOT currently exercise on a regular basis (at least 3 times a week) and/or work in a job that is physically demanding?Are you, or is there any possibility that you might be pregnant?Do you know of any other reason why you should not participate in a programme of physical activity?Is there any further information you feel the instructor should be aware of?
If you answered ‘yes’ to one or more questions: You must consult your doctor before undertaking any fitness appraisal, workshop or other exercise routine with us. You will need to discuss the nature of the activity you are about to undertake and either present your PAR-Q to your doctor or tell them which questions you answered ‘yes’ to. Your doctor needs to advise you as to your suitability for unrestricted physical activity.
If you answered ‘no’ to all questions:
You acknowledge that you are taking responsibility for the accuracy of your replies and the decision that you are physically fit enough for unrestricted physical activity with us.

By signing this PAR-Q you undertake that you have read, understood and correctly answered the questions set out above. You confirm that you wish to participate in our activities which may include aerobic, anaerobic, flexibility, stability, resistance, muscular strength and endurance exercise. You realise that your participation in these activities involves the risk of injury and even the possibility of death. You confirm that you are voluntarily engaging in a level of exercise that you consider acceptable and appropriate for your level of fitness. If you have answered ‘yes’ to any of the questions above, by signing this form you are also confirming that you have taken medical advice relating to your participation and your doctor has confirmed that you are fit enough to participate.
Cancellation clause: A minimum 24 hours’ notice must be given by both parties, you the client and ourselves, ahead of any cancellation of a pre-arranged appointment session by both parties. Failure to do so on behalf of you, the client, waivers any return of pre-paid fees. Failure to do so on behalf of Fit Adultz (a subsidiary of Fit Kidz CIC) will result in a free session for you, the client, at a convenient date/time as agreed between both parties. This clause will be waived in the event of extreme or unavoidable circumstance resulting in late cancellation of a pre-arranged appointment, e.g. hospitalisation or travel delays.
Participant name: *
Date: *