FITNESS 206 GYM

Gym, Classes, Inch Loss Program

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Your Health

Has your doctor ever said that you have a bone or joint problem, such as arthritis, that has been aggravated by exercise or might be made worse with exercise?

Has your doctor ever said that you have raised cholesterol (serum level above 6.2mmol/L)?

Do you have high blood pressure?

Do you have low blood pressure?

Do you have Diabetes Mellitus or any other metabolic disease?

Has your doctor ever said that you have a heart condition and that you should only do physical activity recommended by your doctor?

Have you ever felt pain in your chest when you do physical exercise?

Is your doctor currently prescribing you drugs or medication?

Have you ever suffered from unusual shortness of breath at rest or with mild exertion?

Do you often feel faint, have spells of severe dizziness or have lost consciousness?

Do you know of any other reason why you should not participate in a programme of physical activity?

Physical Actvity Readiness Questionnaire (PAR-Q)

If you answered YES to one or more questions:

If you have not recently done so, consult with your doctor by telephone or in person before increasing your physical activity and/or taking part in exercise. Tell your doctor which questions you answered YES to or present this PAR-Q. After medical evaluation, seek advice from your doctor as to your suitability for:

  1. Unrestricated Physical Activity starting off easliy and progressing gradually, and
  2. Restricted or Supervised Activity to meet your specific needs (at least on an initial basis)

If you answered NO to all questions:

If you answered this PAR-Q accurately,you have reasonable assurance of your present suitability for:

  1. A Graduated Exercise Programme
  2. A Fitness Appraisal

Assumption of Risk

I hereby state that I have read, understood and answered honestly the questions above. I have also read and agree with all terms and conditions.

I state that I wish to participate in activities, which may include aerobic exercise, resistance exercise and stretching.

I am free from injury/illness. I realise that my participation in these activities involves the risk of injury and I accept full responsibility.

Furthermore, I hereby confirm that I am voluntarily engaging in an acceptable level of exercise in the gym.

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