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PARQ
Please answer the following questions (yes/no)
Has your doctor ever said that you have a heart condition and that you should only take part in physical activity recommended by a doctor?

Do you feel any pain in your chest when you do physical exercise?

Do you have any chest pain when you are not doing physical activity ?
Do you have a bone or joint condition that could be made worse by a change in physical activity?
Are you currently take any medication prescribed for blood pressure or a heart condition?
Do you lose your balance because of dizziness or do you ever lose consciousness?
Do you suffer from any type of seizures?
Are you pregnant and have not done any exercise before?

Do you know of any reason why you should not do any physical exercise?

If you have answered yes to any of the above questions we may need you to contact your GP before starting to take part in physical activity.

If you answered no to all questions, you can be reasonably sure that you can start becoming more physically active and take part in the exercise class

I hereby state that I have read, understood and answered honestly the questions in this physical activity readiness questionnaire. I also confirm that I wish to take part in the use of Easy Line equipment which involves low level activity and realize that my participation in these activities involves the risk of injury. I confirm that I am voluntarily engaging in this form of exercise at my own risk.

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Adult Membership £15

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