Important: Please read carefully before filling out. Freediving is a strenuous activity carried out in the underwater environment, which may, under certain conditions, increase your risk of injury. This risk may be significantly increased if you have certain medical conditions. This statement has bean developed to make you aware of these conditions. The purpose of a medical statement is to find out, if you should be examined by a doctor before participating in any Freediving activity events. Please read each question carefully and answer them accurately.
Please explain any “yes” answer.
A positive answer will not necessarily exclude you from participating in any Northland Freediving Club endorsed events / training competitions. But it will require a medical clearance from a physician. This form and your answers will be kept confidential.