PAR-Q Ashton

Full Name*

First NameLast Name

Contact Number

Email

example@example.com

Please read the following questions carefully and check (X) next to the appropriate answers. Answer all questions honestly and to the best of your ability.

YES/ NO*

Rows	Yes	No
Has your doctor ever said that you have a heart condition (had a stroke, heart attack, or heart surgery) and/ or that you should only do physical activity recommended by a doctor?
Do you feel pain in your chest when you do physical activity?
In the past month, have you had chest pain when you were not doing physical activity?
Do you lose your balance because of dizziness or do you ever lose consciousness?
Have you ever been told by a doctor that you have bone, joint, or muscle problems that could be made worse by physical activity?
Do you have a diagnosed illness that could be made worse by physical activity?
Is your doctor currently prescribing medication for your blood pressure or heart condition?
Do you know of any other reason why you should not do physical activity?

If you answered, "Yes," to any of the above questions, you should seek clearance from your medical provider before beginning a new fitness routine.

Fitness Participation Agreement

You, the Member, are aware that there are risks associated with participating in fitness activities and exercise. Your participation is completely voluntary, and you freely accept and fully assume all responsibility for all risks, and all possibilities of personal injury, death, property damage or loss to yourself or any other person as a result of your participation in fitness activities. You and your heirs, next of kin, executors, administrators and assigns agree:

a) to waive all claims, known or unknown, that you have or may have in the future against AshleyDavisTraining, including the owner, employees, volunteers, and site property owners or lessees (the "organization");

b) that AshleyDavisTraining is not liable or responsible for any damage to, loss or theft of your property;

c) to release and forever discharge AshleyDavisTraining from all liablility for any personal injury, death, property damage or loss resulting from your participation in fitness activities due to any cause, including but not limited to negligence (failure to use such care as a reasonably prudent and careful person would use under similar circumstances), breach of any duty imosed by law, breach of contract or mistake in error of judgement of AshleyDavisTraining; and

d) to be liable for and to hold harmless and indemnify AshleyDavisTraining from all actions, proceedings, claims, damages, cost demands, including court costs on a solicitor and own client basis, and liabilities of whatsoever nature or kind arising out of or in any way connected with your participation in fitness activities

Signature of Participant

Date

Agreements & Liability Waiver