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Physical Activity Readiness Questionnaire

 

Regular physical activity is fun and healthy and increasingly more people are starting to become more active everyday. Being more active is very safe for most people. However, some people should check with their doctor before they start becoming much more physically active.

If you are planning to become much more physical active than you are now, start by answering the seven questions in the box below.

If you are between ages of 18 and 69, the PAR-Q will tell you if you should check with your doctor before you start. If you are over 69 years of age, and you are not used to being very active, check with your doctor.

Dated: December 1, 2023

First Participant's Name

First Name*

Last Name*
First Participant's Age Acknowledgment*
First Participant's Date of Birth*
I certify that I am 18 years of age or older
First Participant's Information

Common sense is your best guide when you answer these questions. Please read the questions carefully and answer each one honestly:check YES or NO

1. Has your doctor said that you have a heart condition and/or that you should only do physical activity recommended by a doctor?*
No
Yes
2.Do you feel pain in your chest when you do physical activity?*
No
Yes
3. In the past month, have you had chest pain when you were not doing physical activity?*
No
Yes
4. Do you lose you balance because of dizziness or do you ever lose consciousness?*
No
Yes
6. Is your doctor currently prescribing drugs (for example, water pills) for your blood pressure or heart-condition?*
No
Yes
5. Do you have a bone or joint problem ( for example, back, knee or hip) that could be made worse by a chance in your physical activity?*
No
Yes
7. Do you know of any other reason why you should not do physical activity?*
No
Yes

If you answered YES to one or more questions:

Talk with your doctor by phone or in person BEFORE you start becoming much more physically active or before you have a fitness appraisal. Tell your doctor more about the PAR-Q and which questions you answered yes.


If you answered NO to all questions:

If you answered NO honestly to all PAR

-

Q questions, you can be 

reasonably sure 

that you can:

  • Start becoming much more physically active 

    - begin slowly and build up gradually. This is the safest and easiest way to go.
  • Take part in a fitness appraisal - this is an excellent way to determine your fitness so that you can plan the best way for you to live actively. It is highly recommended that you have your blood pressure evaluated. If your reading is over 144/94, talk with your doctor before you start becoming much more physically active.


DELAY BECOMING MUCH MORE ACTIVE if you are not feeling well because of a temporary illness such as a cold or a fever - wait until you feel better 


PLEASE NOTE:

If your health changes so that you then answer YES to any of the above questions, tell your fitness or health professional. Ask whether you should change your physical activity plan.

Informed Use of the PAR-Q: PK Move Inc., USA Parkour, and their agents assume no liability for persons who undertake physical activity, and if in doubt after completing this questionnaire, consult your doctor prior to physical activity.

____________________________________________________________________

"I have read, understood and completed this questionnaire. Any questions I had were answered to my full satisfaction."

First Participant's Signature*
Second Participant's Name

First Name*

Last Name*
Second Participant's Date of Birth*
Second Participant's Information

Common sense is your best guide when you answer these questions. Please read the questions carefully and answer each one honestly:check YES or NO

1. Has your doctor said that you have a heart condition and/or that you should only do physical activity recommended by a doctor?*
No
Yes
2.Do you feel pain in your chest when you do physical activity?*
No
Yes
3. In the past month, have you had chest pain when you were not doing physical activity?*
No
Yes
4. Do you lose you balance because of dizziness or do you ever lose consciousness?*
No
Yes
6. Is your doctor currently prescribing drugs (for example, water pills) for your blood pressure or heart-condition?*
No
Yes
5. Do you have a bone or joint problem ( for example, back, knee or hip) that could be made worse by a chance in your physical activity?*
No
Yes
7. Do you know of any other reason why you should not do physical activity?*
No
Yes

If you answered YES to one or more questions:

Talk with your doctor by phone or in person BEFORE you start becoming much more physically active or before you have a fitness appraisal. Tell your doctor more about the PAR-Q and which questions you answered yes.


If you answered NO to all questions:

If you answered NO honestly to all PAR

-

Q questions, you can be 

reasonably sure 

that you can:

  • Start becoming much more physically active 

    - begin slowly and build up gradually. This is the safest and easiest way to go.
  • Take part in a fitness appraisal - this is an excellent way to determine your fitness so that you can plan the best way for you to live actively. It is highly recommended that you have your blood pressure evaluated. If your reading is over 144/94, talk with your doctor before you start becoming much more physically active.


DELAY BECOMING MUCH MORE ACTIVE if you are not feeling well because of a temporary illness such as a cold or a fever - wait until you feel better 


PLEASE NOTE:

If your health changes so that you then answer YES to any of the above questions, tell your fitness or health professional. Ask whether you should change your physical activity plan.

Informed Use of the PAR-Q: PK Move Inc., USA Parkour, and their agents assume no liability for persons who undertake physical activity, and if in doubt after completing this questionnaire, consult your doctor prior to physical activity.

____________________________________________________________________

"I have read, understood and completed this questionnaire. Any questions I had were answered to my full satisfaction."

Second Participant's Signature*
Third Participant's Name

First Name*

Last Name*
Third Participant's Date of Birth*
Third Participant's Information

Common sense is your best guide when you answer these questions. Please read the questions carefully and answer each one honestly:check YES or NO

1. Has your doctor said that you have a heart condition and/or that you should only do physical activity recommended by a doctor?*
No
Yes
2.Do you feel pain in your chest when you do physical activity?*
No
Yes
3. In the past month, have you had chest pain when you were not doing physical activity?*
No
Yes
4. Do you lose you balance because of dizziness or do you ever lose consciousness?*
No
Yes
6. Is your doctor currently prescribing drugs (for example, water pills) for your blood pressure or heart-condition?*
No
Yes
5. Do you have a bone or joint problem ( for example, back, knee or hip) that could be made worse by a chance in your physical activity?*
No
Yes
7. Do you know of any other reason why you should not do physical activity?*
No
Yes

If you answered YES to one or more questions:

Talk with your doctor by phone or in person BEFORE you start becoming much more physically active or before you have a fitness appraisal. Tell your doctor more about the PAR-Q and which questions you answered yes.


If you answered NO to all questions:

If you answered NO honestly to all PAR

-

Q questions, you can be 

reasonably sure 

that you can:

  • Start becoming much more physically active 

    - begin slowly and build up gradually. This is the safest and easiest way to go.
  • Take part in a fitness appraisal - this is an excellent way to determine your fitness so that you can plan the best way for you to live actively. It is highly recommended that you have your blood pressure evaluated. If your reading is over 144/94, talk with your doctor before you start becoming much more physically active.


DELAY BECOMING MUCH MORE ACTIVE if you are not feeling well because of a temporary illness such as a cold or a fever - wait until you feel better 


PLEASE NOTE:

If your health changes so that you then answer YES to any of the above questions, tell your fitness or health professional. Ask whether you should change your physical activity plan.

Informed Use of the PAR-Q: PK Move Inc., USA Parkour, and their agents assume no liability for persons who undertake physical activity, and if in doubt after completing this questionnaire, consult your doctor prior to physical activity.

____________________________________________________________________

"I have read, understood and completed this questionnaire. Any questions I had were answered to my full satisfaction."

Third Participant's Signature*
Fourth Participant's Name

First Name*

Last Name*
Fourth Participant's Date of Birth*
Fourth Participant's Information

Common sense is your best guide when you answer these questions. Please read the questions carefully and answer each one honestly:check YES or NO

1. Has your doctor said that you have a heart condition and/or that you should only do physical activity recommended by a doctor?*
No
Yes
2.Do you feel pain in your chest when you do physical activity?*
No
Yes
3. In the past month, have you had chest pain when you were not doing physical activity?*
No
Yes
4. Do you lose you balance because of dizziness or do you ever lose consciousness?*
No
Yes
6. Is your doctor currently prescribing drugs (for example, water pills) for your blood pressure or heart-condition?*
No
Yes
5. Do you have a bone or joint problem ( for example, back, knee or hip) that could be made worse by a chance in your physical activity?*
No
Yes
7. Do you know of any other reason why you should not do physical activity?*
No
Yes

If you answered YES to one or more questions:

Talk with your doctor by phone or in person BEFORE you start becoming much more physically active or before you have a fitness appraisal. Tell your doctor more about the PAR-Q and which questions you answered yes.


If you answered NO to all questions:

If you answered NO honestly to all PAR

-

Q questions, you can be 

reasonably sure 

that you can:

  • Start becoming much more physically active 

    - begin slowly and build up gradually. This is the safest and easiest way to go.
  • Take part in a fitness appraisal - this is an excellent way to determine your fitness so that you can plan the best way for you to live actively. It is highly recommended that you have your blood pressure evaluated. If your reading is over 144/94, talk with your doctor before you start becoming much more physically active.


DELAY BECOMING MUCH MORE ACTIVE if you are not feeling well because of a temporary illness such as a cold or a fever - wait until you feel better 


PLEASE NOTE:

If your health changes so that you then answer YES to any of the above questions, tell your fitness or health professional. Ask whether you should change your physical activity plan.

Informed Use of the PAR-Q: PK Move Inc., USA Parkour, and their agents assume no liability for persons who undertake physical activity, and if in doubt after completing this questionnaire, consult your doctor prior to physical activity.

____________________________________________________________________

"I have read, understood and completed this questionnaire. Any questions I had were answered to my full satisfaction."

Fourth Participant's Signature*
Fifth Participant's Name

First Name*

Last Name*
Fifth Participant's Date of Birth*
Fifth Participant's Information

Common sense is your best guide when you answer these questions. Please read the questions carefully and answer each one honestly:check YES or NO

1. Has your doctor said that you have a heart condition and/or that you should only do physical activity recommended by a doctor?*
No
Yes
2.Do you feel pain in your chest when you do physical activity?*
No
Yes
3. In the past month, have you had chest pain when you were not doing physical activity?*
No
Yes
4. Do you lose you balance because of dizziness or do you ever lose consciousness?*
No
Yes
6. Is your doctor currently prescribing drugs (for example, water pills) for your blood pressure or heart-condition?*
No
Yes
5. Do you have a bone or joint problem ( for example, back, knee or hip) that could be made worse by a chance in your physical activity?*
No
Yes
7. Do you know of any other reason why you should not do physical activity?*
No
Yes

If you answered YES to one or more questions:

Talk with your doctor by phone or in person BEFORE you start becoming much more physically active or before you have a fitness appraisal. Tell your doctor more about the PAR-Q and which questions you answered yes.


If you answered NO to all questions:

If you answered NO honestly to all PAR

-

Q questions, you can be 

reasonably sure 

that you can:

  • Start becoming much more physically active 

    - begin slowly and build up gradually. This is the safest and easiest way to go.
  • Take part in a fitness appraisal - this is an excellent way to determine your fitness so that you can plan the best way for you to live actively. It is highly recommended that you have your blood pressure evaluated. If your reading is over 144/94, talk with your doctor before you start becoming much more physically active.


DELAY BECOMING MUCH MORE ACTIVE if you are not feeling well because of a temporary illness such as a cold or a fever - wait until you feel better 


PLEASE NOTE:

If your health changes so that you then answer YES to any of the above questions, tell your fitness or health professional. Ask whether you should change your physical activity plan.

Informed Use of the PAR-Q: PK Move Inc., USA Parkour, and their agents assume no liability for persons who undertake physical activity, and if in doubt after completing this questionnaire, consult your doctor prior to physical activity.

____________________________________________________________________

"I have read, understood and completed this questionnaire. Any questions I had were answered to my full satisfaction."

Fifth Participant's Signature*
Sixth Participant's Name

First Name*

Last Name*
Sixth Participant's Date of Birth*
Sixth Participant's Information

Common sense is your best guide when you answer these questions. Please read the questions carefully and answer each one honestly:check YES or NO

1. Has your doctor said that you have a heart condition and/or that you should only do physical activity recommended by a doctor?*
No
Yes
2.Do you feel pain in your chest when you do physical activity?*
No
Yes
3. In the past month, have you had chest pain when you were not doing physical activity?*
No
Yes
4. Do you lose you balance because of dizziness or do you ever lose consciousness?*
No
Yes
6. Is your doctor currently prescribing drugs (for example, water pills) for your blood pressure or heart-condition?*
No
Yes
5. Do you have a bone or joint problem ( for example, back, knee or hip) that could be made worse by a chance in your physical activity?*
No
Yes
7. Do you know of any other reason why you should not do physical activity?*
No
Yes

If you answered YES to one or more questions:

Talk with your doctor by phone or in person BEFORE you start becoming much more physically active or before you have a fitness appraisal. Tell your doctor more about the PAR-Q and which questions you answered yes.


If you answered NO to all questions:

If you answered NO honestly to all PAR

-

Q questions, you can be 

reasonably sure 

that you can:

  • Start becoming much more physically active 

    - begin slowly and build up gradually. This is the safest and easiest way to go.
  • Take part in a fitness appraisal - this is an excellent way to determine your fitness so that you can plan the best way for you to live actively. It is highly recommended that you have your blood pressure evaluated. If your reading is over 144/94, talk with your doctor before you start becoming much more physically active.


DELAY BECOMING MUCH MORE ACTIVE if you are not feeling well because of a temporary illness such as a cold or a fever - wait until you feel better 


PLEASE NOTE:

If your health changes so that you then answer YES to any of the above questions, tell your fitness or health professional. Ask whether you should change your physical activity plan.

Informed Use of the PAR-Q: PK Move Inc., USA Parkour, and their agents assume no liability for persons who undertake physical activity, and if in doubt after completing this questionnaire, consult your doctor prior to physical activity.

____________________________________________________________________

"I have read, understood and completed this questionnaire. Any questions I had were answered to my full satisfaction."

Sixth Participant's Signature*
Seventh Participant's Name

First Name*

Last Name*
Seventh Participant's Date of Birth*
Seventh Participant's Information

Common sense is your best guide when you answer these questions. Please read the questions carefully and answer each one honestly:check YES or NO

1. Has your doctor said that you have a heart condition and/or that you should only do physical activity recommended by a doctor?*
No
Yes
2.Do you feel pain in your chest when you do physical activity?*
No
Yes
3. In the past month, have you had chest pain when you were not doing physical activity?*
No
Yes
4. Do you lose you balance because of dizziness or do you ever lose consciousness?*
No
Yes
6. Is your doctor currently prescribing drugs (for example, water pills) for your blood pressure or heart-condition?*
No
Yes
5. Do you have a bone or joint problem ( for example, back, knee or hip) that could be made worse by a chance in your physical activity?*
No
Yes
7. Do you know of any other reason why you should not do physical activity?*
No
Yes

If you answered YES to one or more questions:

Talk with your doctor by phone or in person BEFORE you start becoming much more physically active or before you have a fitness appraisal. Tell your doctor more about the PAR-Q and which questions you answered yes.


If you answered NO to all questions:

If you answered NO honestly to all PAR

-

Q questions, you can be 

reasonably sure 

that you can:

  • Start becoming much more physically active 

    - begin slowly and build up gradually. This is the safest and easiest way to go.
  • Take part in a fitness appraisal - this is an excellent way to determine your fitness so that you can plan the best way for you to live actively. It is highly recommended that you have your blood pressure evaluated. If your reading is over 144/94, talk with your doctor before you start becoming much more physically active.


DELAY BECOMING MUCH MORE ACTIVE if you are not feeling well because of a temporary illness such as a cold or a fever - wait until you feel better 


PLEASE NOTE:

If your health changes so that you then answer YES to any of the above questions, tell your fitness or health professional. Ask whether you should change your physical activity plan.

Informed Use of the PAR-Q: PK Move Inc., USA Parkour, and their agents assume no liability for persons who undertake physical activity, and if in doubt after completing this questionnaire, consult your doctor prior to physical activity.

____________________________________________________________________

"I have read, understood and completed this questionnaire. Any questions I had were answered to my full satisfaction."

Seventh Participant's Signature*
Eighth Participant's Name

First Name*

Last Name*
Eighth Participant's Date of Birth*
Eighth Participant's Information

Common sense is your best guide when you answer these questions. Please read the questions carefully and answer each one honestly:check YES or NO

1. Has your doctor said that you have a heart condition and/or that you should only do physical activity recommended by a doctor?*
No
Yes
2.Do you feel pain in your chest when you do physical activity?*
No
Yes
3. In the past month, have you had chest pain when you were not doing physical activity?*
No
Yes
4. Do you lose you balance because of dizziness or do you ever lose consciousness?*
No
Yes
6. Is your doctor currently prescribing drugs (for example, water pills) for your blood pressure or heart-condition?*
No
Yes
5. Do you have a bone or joint problem ( for example, back, knee or hip) that could be made worse by a chance in your physical activity?*
No
Yes
7. Do you know of any other reason why you should not do physical activity?*
No
Yes

If you answered YES to one or more questions:

Talk with your doctor by phone or in person BEFORE you start becoming much more physically active or before you have a fitness appraisal. Tell your doctor more about the PAR-Q and which questions you answered yes.


If you answered NO to all questions:

If you answered NO honestly to all PAR

-

Q questions, you can be 

reasonably sure 

that you can:

  • Start becoming much more physically active 

    - begin slowly and build up gradually. This is the safest and easiest way to go.
  • Take part in a fitness appraisal - this is an excellent way to determine your fitness so that you can plan the best way for you to live actively. It is highly recommended that you have your blood pressure evaluated. If your reading is over 144/94, talk with your doctor before you start becoming much more physically active.


DELAY BECOMING MUCH MORE ACTIVE if you are not feeling well because of a temporary illness such as a cold or a fever - wait until you feel better 


PLEASE NOTE:

If your health changes so that you then answer YES to any of the above questions, tell your fitness or health professional. Ask whether you should change your physical activity plan.

Informed Use of the PAR-Q: PK Move Inc., USA Parkour, and their agents assume no liability for persons who undertake physical activity, and if in doubt after completing this questionnaire, consult your doctor prior to physical activity.

____________________________________________________________________

"I have read, understood and completed this questionnaire. Any questions I had were answered to my full satisfaction."

Eighth Participant's Signature*
Ninth Participant's Name

First Name*

Last Name*
Ninth Participant's Date of Birth*
Ninth Participant's Information

Common sense is your best guide when you answer these questions. Please read the questions carefully and answer each one honestly:check YES or NO

1. Has your doctor said that you have a heart condition and/or that you should only do physical activity recommended by a doctor?*
No
Yes
2.Do you feel pain in your chest when you do physical activity?*
No
Yes
3. In the past month, have you had chest pain when you were not doing physical activity?*
No
Yes
4. Do you lose you balance because of dizziness or do you ever lose consciousness?*
No
Yes
6. Is your doctor currently prescribing drugs (for example, water pills) for your blood pressure or heart-condition?*
No
Yes
5. Do you have a bone or joint problem ( for example, back, knee or hip) that could be made worse by a chance in your physical activity?*
No
Yes
7. Do you know of any other reason why you should not do physical activity?*
No
Yes

If you answered YES to one or more questions:

Talk with your doctor by phone or in person BEFORE you start becoming much more physically active or before you have a fitness appraisal. Tell your doctor more about the PAR-Q and which questions you answered yes.


If you answered NO to all questions:

If you answered NO honestly to all PAR

-

Q questions, you can be 

reasonably sure 

that you can:

  • Start becoming much more physically active 

    - begin slowly and build up gradually. This is the safest and easiest way to go.
  • Take part in a fitness appraisal - this is an excellent way to determine your fitness so that you can plan the best way for you to live actively. It is highly recommended that you have your blood pressure evaluated. If your reading is over 144/94, talk with your doctor before you start becoming much more physically active.


DELAY BECOMING MUCH MORE ACTIVE if you are not feeling well because of a temporary illness such as a cold or a fever - wait until you feel better 


PLEASE NOTE:

If your health changes so that you then answer YES to any of the above questions, tell your fitness or health professional. Ask whether you should change your physical activity plan.

Informed Use of the PAR-Q: PK Move Inc., USA Parkour, and their agents assume no liability for persons who undertake physical activity, and if in doubt after completing this questionnaire, consult your doctor prior to physical activity.

____________________________________________________________________

"I have read, understood and completed this questionnaire. Any questions I had were answered to my full satisfaction."

Ninth Participant's Signature*
Tenth Participant's Name

First Name*

Last Name*
Tenth Participant's Date of Birth*
Tenth Participant's Information

Common sense is your best guide when you answer these questions. Please read the questions carefully and answer each one honestly:check YES or NO

1. Has your doctor said that you have a heart condition and/or that you should only do physical activity recommended by a doctor?*
No
Yes
2.Do you feel pain in your chest when you do physical activity?*
No
Yes
3. In the past month, have you had chest pain when you were not doing physical activity?*
No
Yes
4. Do you lose you balance because of dizziness or do you ever lose consciousness?*
No
Yes
6. Is your doctor currently prescribing drugs (for example, water pills) for your blood pressure or heart-condition?*
No
Yes
5. Do you have a bone or joint problem ( for example, back, knee or hip) that could be made worse by a chance in your physical activity?*
No
Yes
7. Do you know of any other reason why you should not do physical activity?*
No
Yes

If you answered YES to one or more questions:

Talk with your doctor by phone or in person BEFORE you start becoming much more physically active or before you have a fitness appraisal. Tell your doctor more about the PAR-Q and which questions you answered yes.


If you answered NO to all questions:

If you answered NO honestly to all PAR

-

Q questions, you can be 

reasonably sure 

that you can:

  • Start becoming much more physically active 

    - begin slowly and build up gradually. This is the safest and easiest way to go.
  • Take part in a fitness appraisal - this is an excellent way to determine your fitness so that you can plan the best way for you to live actively. It is highly recommended that you have your blood pressure evaluated. If your reading is over 144/94, talk with your doctor before you start becoming much more physically active.


DELAY BECOMING MUCH MORE ACTIVE if you are not feeling well because of a temporary illness such as a cold or a fever - wait until you feel better 


PLEASE NOTE:

If your health changes so that you then answer YES to any of the above questions, tell your fitness or health professional. Ask whether you should change your physical activity plan.

Informed Use of the PAR-Q: PK Move Inc., USA Parkour, and their agents assume no liability for persons who undertake physical activity, and if in doubt after completing this questionnaire, consult your doctor prior to physical activity.

____________________________________________________________________

"I have read, understood and completed this questionnaire. Any questions I had were answered to my full satisfaction."

Tenth Participant's Signature*
Parent or Guardian's Email Address

Email*

Confirm Email*
Check to receive information, news, and discounts by e-mail.
Parent(s) or court-appointed legal guardian(s) must sign for any participating minor (those under 18 years of age) and agree that they and the minor are subject to all the terms of this document, as set forth above.


By signing below the parent or court-appointed legal guardian agrees that they are also subject to all the terms of this document, as set forth above.
Parent or Guardian's Name

First Name*

Last Name*
Parent or Guardian's Age Acknowledgment*
Parent or Guardian's Date of Birth*
I certify that I am 18 years of age or older
Parent or Guardian's Information

Common sense is your best guide when you answer these questions. Please read the questions carefully and answer each one honestly:check YES or NO

1. Has your doctor said that you have a heart condition and/or that you should only do physical activity recommended by a doctor?*
No
Yes
2.Do you feel pain in your chest when you do physical activity?*
No
Yes
3. In the past month, have you had chest pain when you were not doing physical activity?*
No
Yes
4. Do you lose you balance because of dizziness or do you ever lose consciousness?*
No
Yes
6. Is your doctor currently prescribing drugs (for example, water pills) for your blood pressure or heart-condition?*
No
Yes
5. Do you have a bone or joint problem ( for example, back, knee or hip) that could be made worse by a chance in your physical activity?*
No
Yes
7. Do you know of any other reason why you should not do physical activity?*
No
Yes

If you answered YES to one or more questions:

Talk with your doctor by phone or in person BEFORE you start becoming much more physically active or before you have a fitness appraisal. Tell your doctor more about the PAR-Q and which questions you answered yes.


If you answered NO to all questions:

If you answered NO honestly to all PAR

-

Q questions, you can be 

reasonably sure 

that you can:

  • Start becoming much more physically active 

    - begin slowly and build up gradually. This is the safest and easiest way to go.
  • Take part in a fitness appraisal - this is an excellent way to determine your fitness so that you can plan the best way for you to live actively. It is highly recommended that you have your blood pressure evaluated. If your reading is over 144/94, talk with your doctor before you start becoming much more physically active.


DELAY BECOMING MUCH MORE ACTIVE if you are not feeling well because of a temporary illness such as a cold or a fever - wait until you feel better 


PLEASE NOTE:

If your health changes so that you then answer YES to any of the above questions, tell your fitness or health professional. Ask whether you should change your physical activity plan.

Informed Use of the PAR-Q: PK Move Inc., USA Parkour, and their agents assume no liability for persons who undertake physical activity, and if in doubt after completing this questionnaire, consult your doctor prior to physical activity.

____________________________________________________________________

"I have read, understood and completed this questionnaire. Any questions I had were answered to my full satisfaction."

Parent or Guardian's Signature*
Electronic Signature Consent*
 By checking here, you are consenting to the use of your electronic signature in lieu of an original signature on paper. You have the right to request that you sign a paper copy instead. By checking here, you are waiving that right. After consent, you may, upon written request to us, obtain a paper copy of an electronic record. No fee will be charged for such copy and no special hardware or software is required to view it. Your agreement to use an electronic signature with us for any documents will continue until such time as you notify us in writing that you no longer wish to use an electronic signature. There is no penalty for withdrawing your consent. You should always make sure that we have a current email address in order to contact you regarding any changes, if necessary.


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