PARTICIPANT INFORMATION SHEET
PHYSICAL ACTIVITY READINESS QUESTIONNAIRE (PAR-Q)
If you have answered “Yes” to one or more of the above questions, consult your physician before engaging in physical activity. After a medical evaluation, please seek advice from your physician on what type of activity is suitable for your current condition.
Please also advise of (and explain below) any health conditions you have now or have had in the past which may be relevant to your ability to participate in an exercise class, including but not limited to:
What is your favorite type of exercise and your least favorite (and why)?
If weight loss (or gain) is one of your goals and you are comfortable sharing the information, please maintain a full and honest (i.e., representative) food diary for at least two complete days prior to our next meeting. Please include every bite and taste (including all beverages and water).
(Feel free to email your completed food log to firstname.lastname@example.org or bring to your first class/session.)
, (1) understand that there are risks inherent in any type of physical activity; (2) represent that I am in good physical condition and have no disabilities, diseases, illnesses or other conditions that could prevent me from participating in an exercise program without injuring myself or impairing my health; and (3) represent that I have consulted a physician who has approved my participation in an exercise program of this nature. Should injury occur while participating in this class, I agree to hold Java Fitness, LLC and its employees harmless for any such injuries.
Signature (to be signed before class)