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No Limits Fitness

Physical Activity Readiness Questionnaire

1.   Please read/review

 2.  Complete personal info

3.   Answer health questions

4.  Electronic signature

Please select who will be participating...
AdultMinor
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First Participant's Name
First Name*
Last Name*
Phone*
Select Gender
First Participant's Date of Birth*
Date of Birth
First Participant's Information

PHYSICAL ACTIVITY READINESS QUESTIONNAIRE (PAR-Q)

Physical activity should not be hazardous for most people. The PAR-Q has been designed to identify those individuals who should seek medical attention prior to beginning a physical fitness program.

Height: *
Weight: *

If you are planning to become much more physically active than you are now, start by answering the questions below.  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 start. 

Common sense is your best guide when answering these questions.  Please read the questions carefully and answer each one honestly.

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. Has your doctor ever told you that you have a bone or joint problem (such as arthritis) that has been or may be made worse by physical activity?*
4. Do you ever lose your balance because of dizziness or do you ever lose consciousness?*
5. Is your doctor currently prescribing medication for your blood pressure or heart condition?*
6. Is there any other reason, not mentioned thus far, why you should NOT do physical activity?*

If you answered YES to one or more questions

Talk to your doctor by phone or in person BEFORE you start becoming much more physically active. Tell your doctor about the PAR-Q and to which questions you answered YES.

You may be able to do any activity you want as long as you start slowly and build up gradually. Or, you may need to restrict your activities to those which are safe for you. Talk with your doctor about the kinds of activities you wish to participate in and follow his/her advice.

If you answered NO to all 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.

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. If you are pregnant, talk to your doctor before you start becoming more physically active.

Please note if your health changes so that you would answer YES to any of the above questions, tell your fitness professional. Ask whether you should change your physical activity plan.

You (each member, guest, or participant) agree that if you engage in any physical exercise or activity, or use any club amenity on the premises or off premises including any sponsored club event, you do so  entirely at your own risk.

Likewise, dietary modifications can cause a variety of changes and can create problems, including as it relates to your energy, stamina, appetite, and mood. Any recommendation for changes in diet including the use of food supplements, weight reduction and/or body building enhancement products are entirely your responsibility and you should consult a physician prior to undergoing any dietary or food supplement changes. You agree that you are voluntarily participating in these activities and use of these facilities and premises, and assume all risks of injury, illness, or death. We are also not responsible for any loss of your personal property.

This waiver and release of liability includes, without limitation, all injuries which may occur, regardless of negligence, as a result of: (a) your use of all amenities and equipment in the facility and your participation in any activity, class, program, personal training or instruction; (b) the sudden and unforeseen malfunctioning of any equipment; (c) our instruction, training, supervision, or dietary recommendations; or (d) your slipping and/or falling while in the club, or on the club premises, including adjacent sidewalks and parking areas. This also includes any negligence associated with the presence of or transmission of any bacteria, viruses, or infectious diseases. 

By signing below, you acknowledge that you have carefully read this "waiver and release" and fully understand that it is a release of liability. You expressly agree to release and discharge the health club, and all affiliates, employees, agents, representatives, successors, or assigns, from any and all claims or causes of action and you agree to voluntarily give up or waive any right that you may otherwise have to bring a legal action against No Limits Fitness for negligence, personal injury or property damage. You also agree that this waiver and release also applies to any guests or other participants you bring to No Limits Fitness; should any such persons bring negligence, personal injury, or property damage claims against No Limits Fitness, you agree to defend and indemnify the Club and hold the Club harmless against any such claims.

You further agree that if a court of law finds any part of this agreement to be against public policy or in violation of any state statute or legal precedent, then the remainder of this document will remain in full force.

Promotional and Contact Release

Additionally, you understand that No Limits Fitness occasionally photographs/videotapes client events/sessions and by signing below you provide your express written approval for No Limits Fitness to use your name, image and likeness in any and all media for promotional purposes, with no financial or other remuneration due to you.

By signing below, you hereby grant No Limits Fitness permission to contact you via all methods of communication provided.

First Participant's Signature*
Participant's Address
Address Line 1:*
Street address, P.O. box, company name, c/o
Address Line 2:
Apartment, suite, unit, building, floor, etc.
Country:*
City:*
State/Province:*
Zip/Postal:*
Parent or Guardian's Email Address
Email*
Confirm Email*
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*
Phone*
Select Gender
Parent or Guardian's Date of Birth*
Date of Birth
Parent or Guardian's Information

PHYSICAL ACTIVITY READINESS QUESTIONNAIRE (PAR-Q)

Physical activity should not be hazardous for most people. The PAR-Q has been designed to identify those individuals who should seek medical attention prior to beginning a physical fitness program.

Height: *
Weight: *

If you are planning to become much more physically active than you are now, start by answering the questions below.  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 start. 

Common sense is your best guide when answering these questions.  Please read the questions carefully and answer each one honestly.

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. Has your doctor ever told you that you have a bone or joint problem (such as arthritis) that has been or may be made worse by physical activity?*
4. Do you ever lose your balance because of dizziness or do you ever lose consciousness?*
5. Is your doctor currently prescribing medication for your blood pressure or heart condition?*
6. Is there any other reason, not mentioned thus far, why you should NOT do physical activity?*

If you answered YES to one or more questions

Talk to your doctor by phone or in person BEFORE you start becoming much more physically active. Tell your doctor about the PAR-Q and to which questions you answered YES.

You may be able to do any activity you want as long as you start slowly and build up gradually. Or, you may need to restrict your activities to those which are safe for you. Talk with your doctor about the kinds of activities you wish to participate in and follow his/her advice.

If you answered NO to all 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.

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. If you are pregnant, talk to your doctor before you start becoming more physically active.

Please note if your health changes so that you would answer YES to any of the above questions, tell your fitness professional. Ask whether you should change your physical activity plan.

You (each member, guest, or participant) agree that if you engage in any physical exercise or activity, or use any club amenity on the premises or off premises including any sponsored club event, you do so  entirely at your own risk.

Likewise, dietary modifications can cause a variety of changes and can create problems, including as it relates to your energy, stamina, appetite, and mood. Any recommendation for changes in diet including the use of food supplements, weight reduction and/or body building enhancement products are entirely your responsibility and you should consult a physician prior to undergoing any dietary or food supplement changes. You agree that you are voluntarily participating in these activities and use of these facilities and premises, and assume all risks of injury, illness, or death. We are also not responsible for any loss of your personal property.

This waiver and release of liability includes, without limitation, all injuries which may occur, regardless of negligence, as a result of: (a) your use of all amenities and equipment in the facility and your participation in any activity, class, program, personal training or instruction; (b) the sudden and unforeseen malfunctioning of any equipment; (c) our instruction, training, supervision, or dietary recommendations; or (d) your slipping and/or falling while in the club, or on the club premises, including adjacent sidewalks and parking areas. This also includes any negligence associated with the presence of or transmission of any bacteria, viruses, or infectious diseases. 

By signing below, you acknowledge that you have carefully read this "waiver and release" and fully understand that it is a release of liability. You expressly agree to release and discharge the health club, and all affiliates, employees, agents, representatives, successors, or assigns, from any and all claims or causes of action and you agree to voluntarily give up or waive any right that you may otherwise have to bring a legal action against No Limits Fitness for negligence, personal injury or property damage. You also agree that this waiver and release also applies to any guests or other participants you bring to No Limits Fitness; should any such persons bring negligence, personal injury, or property damage claims against No Limits Fitness, you agree to defend and indemnify the Club and hold the Club harmless against any such claims.

You further agree that if a court of law finds any part of this agreement to be against public policy or in violation of any state statute or legal precedent, then the remainder of this document will remain in full force.

Promotional and Contact Release

Additionally, you understand that No Limits Fitness occasionally photographs/videotapes client events/sessions and by signing below you provide your express written approval for No Limits Fitness to use your name, image and likeness in any and all media for promotional purposes, with no financial or other remuneration due to you.

By signing below, you hereby grant No Limits Fitness permission to contact you via all methods of communication provided.

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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