Physical Activity Readiness Questionaire

 

To Be Completed By All New Bootcampers Before Your First Bootcamp Session

 

Important

Please fill in the following online Par-Q and click on the send button below.

Please also remember to fill in your contact details, and also if you answered yes to any of the questions, then please add more details about your condition in the text box provided at the bottom of the form.
It is important to answer all of the questions honestly and accurately. Thank you.


Have you ever been diagnosed by your doctor as ever having a heart condition that could limit your activity levels?

Have you ever felt pain in your chest area whilst doing exercise or physical exertion?

Have you ever lost balance because of dizziness or have you ever lost your consciousness whilst exercising?

Do you have any bone or joint problems?

Are you currently being prescribed drugs by your doctor for your blood pressure or a heart condition?

Do you have Type 1 or Type 2 Diabetes?

Are you currently Pregnant?

Have you ever suffered shortness of breath with mild exertion?

Have you ever suffered fatigue with normal activities?

Have you ever experienced sharp pain in your lower leg when walking uphill or upstairs which disappears within 1-2 minutes of stopping?

If you have answered “Yes” to any of the above questions then please speak to a member of the Plymouth Hoe Bootcamp team as you may need written authorisation from your doctor before partaking in exercise or physical activity.


Do you Smoke?

Have you ever been told by your doctor or other professional that your blood pressure is too high?

Do you suffer from high cholesterol?

Do you have a family history of heart disease?

Are you physically inactive in both your work & leisure time?

Is your waist measurement more than 38 inches? (100 cm)

Do you know any reason why you should not do physical activity?

Questions 11-17 If you have answered “YES” to 2 or more of these questions then you are advised to limit your activities to a low to moderate intensity activity well within your current capacity and sustainable for a prolonged period of time. Examples of this include walking, slow cycling, and gentle swimming.

Males 45 and over and females 55 and over not accustomed to regular physical activity are recommended to limit their activities to a moderate intensity in the absence of their doctor’s consent to exercise at a higher level.


Terms & Conditions

In consideration of being able to take part in exercise and physical activity organised by Plymouth Hoe Bootcamp I acknowledge that:-

1. I have completed this Health Questionnaire (Par-Q) accurately and to the best of my knowledge and belief.

2. To the best of my knowledge, I know of no reason why I should not participate in any of the programmes and activities run by Plymouth Hoe Bootcamp, I hereby declare myself free of any condition, disease, impairment, infirmity or illness that may affect my participation. I agree to inform Plymouth Hoe Bootcamp and where appropriate provide written consent from my doctor should such a condition or complaint arise, before continuing with any physical activity or exercise.

3. I agree to abide by all verbal and written notices regarding safety whilst exercising with Plymouth Hoe Bootcamp. I agree only to use the equipment and facilities relevant to my capabilities or that I have been inducted on and/ or am fully conversant with.

4. In the case of myself not understanding a particular piece of equipment or exercise being given or risks and dangers involved in a particular piece of equipment or exercise being given I understand I will have the opportunity to ask questions about the activities, use of the equipment, and other related issues. I agree not to exercise until any questions I have asked or concerns raised have been answered to my satisfaction and are fully understood by myself.

5. I am aware of and understand the potential risks and dangers associated with physical activity and exercise including the use of equipment and I am voluntarily participating in these activities with the knowledge of the risks and dangers involved.

6. Plymouth Hoe Bootcamp accepts no liability for death, injury or illness resulting from my failure to disclose any relevant medical impairment or condition or from my misuse of facilities & equipment.

7. Without prejudice to the above, Plymouth Hoe Bootcamp accepts no liability for loss of whatsoever nature and howsoever arising caused to me or suffered by me whilst exercising WITH THE EXCEPTION of any liability or loss that is caused by the negligent acts or omissions of Plymouth Hoe Bootcamp.


Please fill in your Name and contact details below.


If you answered yes to any of the previous questions, please could you provide us with more information in the box below.


More Information About Your Conditions.(If You Have Answered Yes)

Full Name

Email

Telephone