TAH PARQ

Please answer YES or NO to the following:*

	YES	NO
Do you take part in any form of exercise on a regular / semi-regular basis?
Do you understand that the route takes in mountainous terrain that may not be paved?
Have you read and understood the 'ESSENTIALS', as provided in the trip literature?
Do you currently have any injuries, aches or pains that may hinder or be made worse by today's activity?
Do you have a diagnosed illness that could be made worse by physical activity?
Do you have any allergies?
Do you currently take any medication for blood pressure or a heart condition?
Do you lose your balance because of dizziness or do you ever lose consciousness?
Do you know of any other reason why you should not do physical activity?
Is there anything else that may be relevant to today's activity?

Where relevant, please give further details to your above answers. Especially in the case of illness, injury or pain:
Emergency contact Name*

First NameLast Name
Emergency contact number*

Area CodePhone Number
Fitness Participation Agreement

I have voluntarily chosen to participate in this hiking activity offered by Take A Hike UK and I have read and understood the 'ESSENTIALS' provided in the lead up to this trip. I have answered the questions above to the best of my ability and affirm that my physical condition is good and I have no known conditions that would prevent me from participation. I acknowledge that participation is at my own pace and comfort level and that I may discontinue my participation at any time. Furthermore, I agree to self-determine my exertion through good judgement and to discontinue any activity that exceeds my personal limitations. I understand that by signing this agreement that I hereby waive and release Take A Hike UK, it's owners, staff and all relevant employees in any way from liabilities or demands as a result of injury, loss, or adverse health conditions as a result of my participation.

I affirm that I have read and understand ths document and I wish to participate in fitness activities.
Please type your full name*
This is by way of digital signature
Today's date*

DayMonthYear
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PARTICIPATION QUESTIONNAIRE