PAR-Q / Medical History Questionnaire
Lean Boot Camps trades under Lean Personal Training Ltd

All information in this Physical Activity Readiness Questionnaire (PAR-Q) will be stored securely and confidentially and not passed to any third parties. Lean Boot Camps hold public liability insurance to the amount of £5m.

Regular exercise is associated with many health benefits however any marked change of activity may increase the risk of injury. Completion of this questionnaire is the first step when planning to increase the amount of physical activity in your life.

If you answer Yes to any of the below questions, talk with your doctor BEFORE you become more physically active. Tell your doctor you intend to exercise and to which questions you answered yes. If you honestly answered No to all questions you can be reasonably positive that you can safely increase your level of physical activity gradually.

If your health changes so that you would then answer yes to any of the below questions, seek guidance from a doctor before continuing. Please stay hydrated and work at your own pace during the exercise sessions. Take rest where needed and inform the personal trainer if you feel unwell or concerned at any time.

Please read each question carefully and answer honestly / tick where appropriate.
Email address *
Has your doctor ever advised against you participating in physical exercise? *
When you participate in physical activity, do you feel pain in your chest? *
Have you had chest pain in the past three months? *
Does any member of your family aged 55 or less have an history of heart disease ? *
Do you ever lose consciousness or do you lose your balance because of dizziness? *
Do you have a joint or bone problem that may be made worse by an increase in your physical activity? *
Have you ever suffered from high or low blood pressure? *
Are you currently taking medications for your blood pressure or a heart condition? *
Are you pregnant, or have you been pregnant in the last 6 months? *
Have you ever suffered from high cholesterol? *
Do you have insulin dependent diabetes? *
Are you 69 years of age or older? *
Have you ever suffered from asthma, chronic bronchitis or any other chest ailments? *
Have you ever suffered from severe headaches or migraines? *
Have you ever suffered from severe back pain? *
Are you recovering from any recent illness, operation or injury? *
If you answered yes, please give details in 'other'
Are you currently taking any form of medication? *
If you answered yes, please give details in 'other'
Do you know of any reasons why you should not exercise or increase your physical activity? *
If you answered yes, please give details in 'other'
Name *
Your answer
Address *
Your answer
Postcode *
Your answer
Mobile *
Your answer
Email *
Your answer
Date Of Birth *
Your answer
Next of kin / name of emergency contact *
Your answer
Telephone number for your next of kin / emergency contact *
Your answer
Disclaimer agreement *
By ticking the following 'Agree' button you have agreed to participate in Lean Boot Camps' exercise sessions which includes strength training, circuit training, kettlebells, skipping, running, agility drills, team games, boxing, step aerobics, flexibility and mobility exercise and that you have answered all the above Physical Activity Readiness Questionnaire (PAR-Q) correctly and honestly. I am aware of and understand the risks associated with physical activity including the use of equipment and I am voluntarily participating in these activities. I understand that these sessions are in the outdoors and I am aware of the risk of injury or even death and I am voluntarily participating. I have completed the PAR-Q and I agree that I have no health issues that will be affected by attending Lean Boot Camps. Should my medical condition change, I agree to inform Lean Personal Training Ltd before continuing with the activities. I know of no reason why I should not participate in any of the programmes and activities at Lean Boot Camps. If necessary I will gain and provide written consent from my doctor to allow me to participate in the activities. I agree to follow safety instructions whilst at Lean Boot Camps. If I choose not to take the advice given, I do so voluntarily and accept liability for all resulting injuries or damage. I do hereby waive, release and discharge Lean Personal Training Ltd from any and all responsibility or liability for injuries or damages resulting from my participation in any activities or my use of equipment or facilities in the activities. This PAR-Q has been completed accurately to the best of my knowledge and belief. I have read and understood the Medical PAR-Q and Disclaimer form by Lean Boot Camps and by booking and attending the activities I agree to be bound by their conditions. Thank you for taking your time to complete the PAR-Q and we look forward to meeting you soon.
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