Physical Activity Readiness Questionnaire (PAR-Q)
All information in this Physical Activity Readiness Questionnaire (PAR-Q) will be stored securely and confidentially and not passed on to third parties.

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 your intent 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 / cross country race. 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 *
Name *
Your answer
Address (inc Postcode) *
Your answer
Mobile *
Your answer
Occupation *
Your answer
Date of Birth *
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Has a doctor ever said you have a heart condition and you should only do physical activity recommended by a doctor? If Yes provide details *
When you do physical activity, do you feel pain in your chest? *
When you were not doing physical activity, have you had chest pain in the past month? If Yes provide details *
Is there any history of heart disease in your parents or siblings aged 55 or less? If Yes provide details *
Do you ever lose consciousness or do you lose your balance because of dizziness? If Yes provide details *
Do you have a joint or bone problem that may be made worse by a change in your physical activity? If Yes provide details *
Have you ever suffered from high or low blood pressure? *
Is a doctor currently prescribing 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? If Yes provide details *
Have you ever suffered from severe headaches or migraines? If Yes provide details *
Have you ever suffered from severe back pain? If Yes provide details *
Are you recuperating from any recent illness, operation or injury? If Yes please provide details below (under other) *
Are you currently taking any form of medicine? If Yes please provide details below (under other) *
Do you know of any reasons why you should not exercise or increase your physical activity? If Yes please provide details below (under other) *
Next of Kin / Emergency Contact
Your answer
Next of kin / Emergency Contact Telephone Number *
Your answer
Disclaimer Agreement
By ticking the following 'Agree' button you have agreed to participate in one of the Hove Hornets Fitness and/or Hove Hornets Run Club and assisting personal trainers (herein, collectively the “Trainers”) exercise sessions which includes, but is not limited to, strength training, circuit training, kettlebells, skipping, running, agility drills, team games, boxing, step aerobics, cross country race, flexibility and mobility exercise and that you have answered all the above Physical Activity Readiness Questionnaire (PAR-Q) correctly and honestly. You agree to participate upon the understanding and condition that:-

1. You acknowledge that the training sessions / races take place outdoors in all weather conditions and all seasons and that there are risks involved including (but not limited to) those caused by terrain, facilities, temperature, weather, your current physical condition, equipment and the actions of other participants / the general public. You are aware of the medical risks associated with participating in an intense exercise program. You agree that by participating in physical exercise or training activities, you do so entirely at your own risk. You agree that you are voluntarily participating in these activities and use of these facilities and premises and assume all risks of injury, illness, or death.

2. You understand that if you answered YES to any of the Medical History Questions / Health Questionnaire on this PAR-Q you are required to seek medical advice before commencing any training. Furthermore you understand that if you choose to commence training without seeking such advice, you are placing yourself at risk willingly and are therefore entirely responsible for any consequences arising from such participation.

3. You understand that Hove Hornets Fitness or any of the team may not be held responsible for any injuries or ill health of any kind arising from attendance at any training session / races. You are hereby waiving and releasing the Trainers from any and all claims, costs, liability, expenses or judgments including lawyer’s fees and court cost (herein, collectively “Claims”) arising out of your participation in the Trainers programs or any illness or injury resulting there from, and hereby agree to indemnify and hold harmless the Trainers from and against any and all such Claims.

4. You acknowledge that you have carefully read this “waiver and release” and fully understand that it is a release of liability. You expressly agree to release and discharge the Trainers from any and all claims or causes of action and you agree to voluntarily give up or waive any right that you may otherwise have to bring a legal action against the ‘Trainers’ personal injury or property damage. To the extent that statute or case law does not prohibit releases for negligence, this release is also for negligence. If any portion of this release from liability shall be deemed by a Court of competent jurisdiction to be invalid, then the remainder of this release from liability shall remain in full force and effect and the offending provision or provisions severed here from. By signing this release, I acknowledge that I understand its content and that this release cannot be modified orally.

5. When you become a member of or renew your membership with Hove Hornets Running Club you can also choose to be registered as a member of England Athletics (you will have to register with England Athletics if you ever compete for the club in competition Under UKA Rules). If you tick the box below we will provide England Athletics with your personal data which they will use to enable access to an online portal for you (called myAthletics). England Athletics will contact you to invite you to sign into and update your MyAthletics portal (which, amongst other things, allows you to set and amend your privacy settings). If you have any questions about the continuing privacy of your personal data when it is shared with England Athletics, please contact dataprotection@englandathletics.org.

6. In undertaking a Hove Hornets Fitness class, session or course I understand that Hove Hornets Fitness will collect certain information about me which will include your name, date of birth, gender, email address, address, telephone number. This information will be used to administer my classes, session or course and provide communication, regular updates and information via email.

7. I grant full rights permission to Hove Hornets Fitness to use my likeness resulting from the photography, video filming, recordings and any reproductions or adaptations of the images for any legitimate purpose. This might include (but is not limited to), the right to use them in their printed and online publicity, social media, press releases and funding applications.

Please click the 'Agree' button now then submit your form and we look forward to meeting you soon.
Disclaimer Agreement *
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A copy of your responses will be emailed to the address you provided.
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