• PHYSICAL ACTIVITY READINESS QUESTIONNAIRE (PARQ)

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  • What is your Date of Birth?*
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  • PLEASE READ FOLLOWING QUESTIONS CAREFULLY

    If you answer any of the ‘yes’ responses below you may need your doctor’s consent before you participate in a class.
  • Has a doctor ever said that you have a heart condition and not to take part in physical activity?*
  • Has a doctor ever recommended medication for your blood pressure or a heart condition?*
  • Do you have chest pain brought on by physical activity? Or developed chest pain in last month?*
  • Do you lose consciousness or fall over as a result of dizziness?*
  • Are you aware through your own experience or from doctor’s advice of any other reason why you should not do physical activity without medical supervision?*
  • Are you currently taking any medication?*
  • Do you have any medication or other allergies?*
  • Do you have any pre existing medical conditions that affects your ability to exercise (including pregnancy)*

  • INFORMED CONSENT

  • I realise that my body’s reaction to physical activity is not totally predictable. Should I develop a condition that affects my ability to exercise, I will inform my instructor immediately and stop exercising if necessary. I take full responsibility for monitoring my own physical condition at all times.  If you have answered ‘YES’ to any of the above questions, are pregnant, have a history of heart disease or suffer from any other medical condition, we strongly recommend that you obtain your doctor’s consent that you may take part in this class/training event.

    You agree by signing/agreeing below that:

    1. If I have answered yes to any of the questions, I have consulted my doctor and gained their agreement to undertake a physical activity programme.
    2. If my health changes at anytime so that I would answer yes to any of the above then I will cease exercising and consult my doctor
    3. I am taking part in this class/training event at my own risk and Zumba/Broadway Boogie and/or my Instructor will not be responsible for any injury or loss or harm of any kind that may result directly or indirectly from taking part in this class/training event, other than death or personal injury caused by negligence.                                                

  • IN CASE OF EMERGENCY PLEASE CONTACT:

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  • PHOTOS/VIDEO CONSENT

    On occasion part or whole of the class may be photographed or short videos taken for use in promotion purposes such as advertising or shared on social media by Claire Omand (ClaireODance & other social media channels as appropriate)

  • Do you give your consent to show off how fabulous you are?*

  •  STAYING IN TOUCH

    “Claire O Dance” would love to stay in touch with you to let you know about upcoming events, special offers etc that may be of interest to you.

  • Would you like to stay in touch?*

  • PARTICIPANTS PRIVACY POLICY

    Claire Omand – Licensed Zumba & Broadway Boogie Instructor

  • As your Dance Fitness Instructor, I am committed to protecting your privacy. This privacy policy sets out how I use and protect any information that you give me.

    Your personal data

    As an attendee of my classes, I collect, store and use the personal data that you provide me. I do this so that I can effectively manage my classes and ensure that as a participant you are kept informed and safe.

    I may use your data to contact you with class updates and wider group exercise related opportunities I think you may be interested in.

    I will use your data to keep me informed about any health or wider needs you have that I need to consider whilst delivering your class/es.

    If you have provided me with emergency contact details, I will use this data when required.

    Some of the data that I collect from you is ‘specialist category’. This includes (not exhaustively) any data relating to disabilities and health. I collect and use this data to enable me to tailor activities to your needs.

    Unless you have given me separate written consent, I will cease to contact you 6 months after your stop attending my class/es. At this point I will also delete/destroy all personal data that is not linked to financial records.

    I will store any personal data linked to financial records for a 6-year period. HM Revenue and Customs (HMRC) have the right to inspect financial information relating to the previous 6 years and require all trading entities to keep financial records for this length of time.

    I will not share your personal data. All data you provide to me is stored on a password protected device and/or locked away. The only exception to this rule is when I carry paper copies of your personal data to the class/es that you attend. I must do this so that I have your health needs and emergency contact details to hand should they be required.

    You may request details of personal data which I hold about you or withdraw your consent at any time. You can contact me on 07837389717 or claireozumba@gmail.com.

    If you have any concerns about my information rights practices, please contact me in the first instance. If you have any concerns, you can then raise them here www.ico.org.uk/concerns or by calling 03031231113.

    Claire Omand

    (14th August 2024)

  • All information provided will be kept private and confidential. We will not use your data for any other purpose and we will never share your data with third party organisations. Please read the above privacy policy and answer below to indicate your consent to share this information with me.*
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