RYG Women's Fitness

Name

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Mobile Number

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Telephone Number

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Email Address

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D.O.B.

Emergency Contact Name

Emergency Contact Number

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Emergency Contact Number

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Do you wish to be added to the mailing list for news/notifications for other classes?

YesNo

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: check YES or NO.

Has your Doctor ever said you have a heart condition and that you should only do physical activity as recommended by a doctor?

YesNo

Do you wish to be added to the mailing list for news/notifications for other classes?

YesNo

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

YesNo

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

YesNo

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?

YesNo

Is your Doctor currently prescribing you medication for your blood pressure or heart condition?

YesNo

Do you know of any other reason why you should not do physical activity?

YesNo

Asthma or respiratory problems?

YesNo

Any sustained injuries or illness?

YesNo

Any allergies?

YesNo

Is your child taking any medication?

YesNo

Has your Doctor ever advised your child not to exercise?

YesNo

If you have answered 'YES' to any of the above questions please provide details

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 questions: It is reasonably safe for you to participate in physical activity, gradually building up from your current ability level.

TERMS AND CONDITIONS

*If your health changes at any time during your participation you must inform RYG Women’s Fitness of the details, in writing;

*In the event of the necessity of class cancellation participants will be notified via the WhatsApp group as early as possible;

*Photos/video footage may be taken for marketing purposes. You will be advised of this prior to footage being taken;

*All client information will be kept strictly private and confidential. Full privacy policy is on the website: www.rygwomensfitness.com

Cancellation Policy

*12 hours notice of cancellation is required for all appointments;

*Notice of less than 12 hours notice will incur full payment of the session fee.

Fee Charging Policy

*Payment for sessions must be made at the time of booking;

*All monies paid are non-refundable;

*All sessions are non-transferable.

Disclaimer - As a participating member of RYG Women’s Fitness Classes I take all responsibility or liability for any injuries or damages resulting from my participation in fitness class activities. I understand that exercise and fitness activities involve a risk of injury and whilst every care is taken by RYG Women’s Fitness during these sessions I agree that I attend at my own risk and that I am voluntarily participating in these activities.

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.

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

Signature

Print Name

Date

RYG Women's Fitness

PHYSICAL ACTIVITY QUESTIONNAIRE(PAR-Q)