Active Fit Club Registration and Pre-Assessment Risk Form (PARQ)
Welcome to Fit Club! Please take a few minutes to answer all questions as accurately as possible thanks!
Sign in to Google to save your progress. Learn more
Email *
What is your name? *
Age *
Birth Date *
Residential Postal Code *
Contact Number *
Has your doctor ever said that you have a heart condition and that you should only do physical activity recommended by a doctor? *
In the past month, have you had chest pain when you were not doing physical activity? *
Do you lose your balance because of dizziness or do you ever lose consciousness? *
Do you have a bone or joint problem (for example, back, knee or hip)that could be made worse by a change in your physical activity? *
Do you feel pain in your chest when you do physical activity? *
Is your doctor currently prescribing drugs (for example, water pills)for your blood pressure or heart condition? *
Do you know of any other reason why you should not do physical activity? *
Have you had your vaccination? *
Have you had Covid-19 before? *
Emergency Contact Name? *
Emergency Contact number? *
What do you want to achieve? *
Acknowledgement: I hereby declare that the information provided is true and correct. *
Required
Disclaimer*
Weight loss results in Fit Club Singapore are not typical, individual results may vary

Every exercise has it risk and we encourage every participant to inform any coach at anytime when unsure or not feeling well.

Fit Club Singapore is not liable for any damage or injuries sustained during or after class, participants digression is advised.

Thank you so much for completing the registration form!    
A copy of your responses will be emailed to the address you provided.
Submit
Clear form
Never submit passwords through Google Forms.
reCAPTCHA
PrivacyTerms
This content is neither created nor endorsed by Google. - Terms of Service - Privacy Policy

Does this form look suspicious? Report

Google Forms