Arthur Mom & Tot Fitness
Hello mommies! I'm very, very excited to have you all join my fitness class (Wednesdays Jan 17 - Feb 21). It's going to be a great time!!! Below is a brief area for contact/registration purposes followed by the Physical Readiness Questionnaire (PAR-Q) for every participant to fill out. The PAR Q questionnaire ensures you are safe to participate in this class without a doctor's note.
Name *
Your answer
Email *
Your answer
Emergency Contact *
Your answer
Emergency Phone # *
Your answer
Now lets see your Physical Readiness!
Has your doctor ever said that you have a heart condition and that you should only do exercise recommended by a doctor? * *
Do you feel pain in your chest when you do physical activity? * *
In the past month, have you had chest pain when you were not participating in physical activity? * *
Do you lose your balance because of dizziness or do you ever lose consciousness? *
Do you have a bone injury in your back, knee or hip that could be made worse by a chance in your physical activity? * *
Is your doctor prescribing drugs for your blood pressure or heart condition? * *
Do you know of any reason why you should not participate in physical activity? *
Have you had surgery in the last two years? * *
Are you currently on any medications? *
Do you have any pain or stiffness in your back, knee, hip shoulders or elsewhere? *
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