PHYSICAL ACTIVITY READINESS QUESTIONNAIRE (PAR-Q)

PHYSICAL ACTIVITY READINESS QUESTIONNAIRE (PAR-Q)
Name*

First NameLast Name
Email*
example@example.com
Phone Number*

Area CodePhone Number
Emergency Contact Person and Cell
Name*

First NameLast Name
Phone Number*

Area CodePhone Number
Please follow us on Facebook and Instagram for instant updates!

I have enrolled in a program offered through Blue Zone Wellness and Fitness Centre

First NameLast Name
Insert your name in the space available.
Participant’s Signature

Clear
Insert your name in the space available.
Participant’s Signature (if participating in photos/videos please sign your name. If you are disagreeing, please put an "X")

Clear
Witness Name

First NameLast Name
Date

MonthDayYear
Date

Should be Empty: