PARQ - ALL CLASSES

Sofunk® Dance Fitness Registration & Health Check

Physical Activity Readiness Questionnaire (PAR-Q)

* Indicates required field

Name *

First

Last

Phone Number *

Email *

Emergency Contact Name & Number *

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 (for example, back, knee or hip) that could be made worse by a change in 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? *

If you have answered:
'YES’ to one or more question:
You are required to gain consent from your doctor before participating in Sofunk®Dance Fitness Outdoors
‘NO’ to all questions:
You acknowledge that you are taking responsibility for the accuracy of your replies and the decision that you are physically fit enough for unrestricted physical activity.

DECLARATION
By submitting this PARQ Form :-

I undertake that I have read, understood and correctly answered the questions set out above.
I wish to participate in Sofunk®Dance Fitness Outdoors and I understand that my participation in this activity involves the risk of injury.
I confirm I am voluntarily engaging in a level of exercise that I consider acceptable and appropriate to my level of fitness.
If I have answered ‘YES’ to any of the questions above, by submitting this form I am also confirming that I have taken medical advice relating to my participation and my doctor has confirmed that I am fit enough to participate.

SUBMIT