• PAR-Q + Liability Waiver

    Complete this Physical Activity Readiness Questionnaire and Liability Waiver before participating in training with Coach Freddie Mountain.
  • Date of Birth*
     - -
  • Format: (000) 000-0000.
  • 1. Has your doctor ever said that you have a heart condition and that you should only do physical activity recommended by a doctor?*
  • 2. Do you feel pain in your chest when you do physical activity?*
  • 3. In the past month, have you had chest pain when you were not doing physical activity?*
  • 4. Do you lose your balance because of dizziness or do you ever lose consciousness?*
  • 5. Do you have a bone or joint problem that could be made worse by a change in your physical activity?*
  • 6. Is your doctor currently prescribing drugs (for example, water pills) for your blood pressure or heart condition?*
  • 7. Do you know of any other reason why you should not do physical activity?*
  • 8. Are you pregnant or have you given birth in the last 6 months?*
  • 9. Do you have any chronic medical conditions (such as diabetes, asthma, or epilepsy)?*
  • 10. Are you currently taking any medications that may affect your ability to exercise safely?*

  • Liability Waiver
    I acknowledge that I am participating in training at my own risk. I understand that Coach Freddie Mountain is not yet a qualified personal trainer or a medical professional, and that I should consult my physician before beginning any exercise program. I agree to assume full responsibility for any risks, injuries, or damages known or unknown which I might incur as a result of participating in this training.

  • Date Signed*
     - -
  • Should be Empty: