PAR-Q Registration Form

  • Aqua Fitness & Therapy Class PAR-Q & Registration Form.

    Physical Activity Readiness Questionnaire (PAR-Q) This form can be completed and submitted online. You can write your signature by using your mouse (laptop) or finger (mobile phone). Looking forward to seeing you soon, Yvette 😊
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  • Are you able to receive text messages from the phone number above?
  • Has your doctor ever said that you have a bone or joint problem, such as arthritis, that has been aggravated by exercise or might be made worse with exercise?*
  • Do you have high blood pressure?*
  • Do you have low blood pressure?*
  • Has your doctor ever said that you have a heart condition and that you should only do physical activity recommended by a doctor?*
  • Have you ever felt pain in your chest when you do physical activity?*
  • Have you ever suffered from unusual shortness of breath at rest or with mild exertion?*
  • Do you often feel faint, have spells of sever dizziness or have lost consciousness?*
  • Do you know of any reason why you should not participate in a program of physical activity?*

  • If you answered 'yes' to one or more questions: 

    If you have not recently done so, it is recommneded you consult with your doctor by telephone or in person before increasing your physical activity. Tell your doctor what questions you answered 'yes'' to on the PAR-Q or present your PAR-Q copy. After medical evaluation, seek advice from your doctor as to your suitability for:

    - Unrestricted physical activity starting off easily and progressing gradually,

    - Restricted or supervised activity to meet your specific needs, at least on an initial basis 

    No to all questions:

    If you answered your PAR-Q accurately, you have reasonable assurance of your present suitability to take part in physical gym activity. 

     

    Assumption of risk:

    I hereby state that I have read, understood and answered honestly the questions of the PAR-Q. I also state I wish to participate in activites that may include aerobic exercise, resistance training and stretching. I realise that my participation in these activites involves the risk of injury. Furthermore, I hereby confirm that I am voluntarily engaging in an acceptable level of exercise. I understand there is no Lifeguard on duty during my sessions and I take full resposibilty for my own safety and wellbeing.

    Terms & conditions: 

    I understand that there will be no refunds for missed classes (efforts will be made to offer make-up classes, space permitting).


    I hereby state I have read and agree to the terms & conditions stipulated by Peacehaven Aqua Fitness and Therapy.

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