ParQ – Physical Activity Readiness Questionnaire If you are between the ages of 15 and 69, the PAR-Q will tell you if you should check with your doctor before you significantly change you physical activity patterns. If you are over 69 years of age and are not used to being very active, check with your doctor. We have added questions on any additional needs to ensure members are supported if living with a disability. Please read each question carefully and answer honestly by indicating YES or NO. Name(required) Preferred pronouns:(required) Date of Birth(required) Phone Number (this will be shared with track & trace officials if necessary)(required) Email(required) Emergency contact's name & relationship(required) Emergency contact's phone number(required) You agree to notify us if you you develop a persistent cough, high temperature or loss of taste or smell – or if you test positive for Covid-19.(required) If you live with a medical or psychological condition, how can we support you to ensure you get the best out of training? How does your condition affect you and how can we support your jiu jitsu journey?(required) Has your doctor ever said you have a heart condition and that you should only do physical activity recommended by a doctor?(required) Do you feel pain in your chest when you do physical activity?(required) In the past month, have you had a chest pain when you were NOT doing physical activity?(required) Do you lose balance because of dizziness or do you ever lose consciousness?(required) Do you have a bone or joint problem ( for example back, knee or hip) that could be made worse by a change in your physical activity?(required) Is your doctor currently prescribing medication for your blood pressure or heart condition?(required) Do you know of any other reason why you should not take part in physical activity? If YES please comment:(required) If you answered YES to one or more of the last 7 questions:You should consult with your doctor to clarify that it is safe for you to become physically active at this current time and in your current state of health. If you answered NO:It is reasonably safe for you to participate in physical activity, gradually building up from your current ability level. A fitness appraisal can help determine your ability levels. By submitting this form you confirm you have read, understood and accurately completed this questionnaire. You confirm that you are voluntarily engaging in an acceptable level of exercise, and your participation involves a risk of injury. If you answer YES to one of the questions above, you agree to seek medical advice and discuss training with your GP before exercising. Please note, this PAR Q becomes invalid if your condition changes so that you would answer YES to any of the 7 questions. It’s a requirement that we store your contact details so that if necessery they can be used for track and trace purposes should anyone test positive for Covid-19, by filling this form and training with us you agree to your contact details being shared with track & trace officials should it be required. Your data will be stored securely as per our Privacy Notice available on the website at the bottom of the FAQs. The data collected within this form is done so in line with our privacy notice for members. Please read our privacy notice in full before completing this form. The privacy notice sets out the legal basis for processing this data, how long we will keep your data for, how we protect your personal information, and your rights in relation to the personal data that we hold on you. Submit Δ Share this:FacebookTwitterWhatsAppEmail