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Pre Activity Readiness Questionaire Form  (PAR-Q-Form)

Please fill out the following form
in order to participate within our Gym and our activities.

Personal Details:
Address:
Gender?
Emergency Contact:
Medical Questions:
Answer the following questions as honestly as you can and provide as much relevant information you think is necessary. Answer the following questions by checking the box if the answer is YES to the question (if you should answer YES to any of the questions please provide further details in the space provided). 
Do you currently or have you ever suffered from any of the following conditions?
If you answered YES / checked any box above, please give more details:
Medical History:
Do you crrently receive meical care or do any of the following affect you?
If you answered YES / checked any box above, please give more details:

Thanks for submitting!

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