Men's Boxing Group- Client Information and Sign Up
Hello and thank you for your interest in the Men's Mental health group made possible by the West Essex MIND funding. The project is aimed at Men aged 18+ and especially men in their 30s - 50s who might have struggled with their mental health, felt suicidal, had suicidal thoughts or been in some dark places. We're a friendly gym with people from all sorts of backgrounds training with us. There's no judgment and no expectation for you to share or talk about anything you don't want to.

The sessions start on Tues 12 Sept from 7.15 - 8.15pm for 10 weeks ran by Simeon Dennis and Carly Attridge. We'll focus on using boxing as a tool to help us to improve our physical and mental health, do some light touch wellbeing activities and mix with some like minded men! The sessions are free to access and open to anyone who feels they might benefit.

The sessions are aimed to be high energy, fun and non-contact, although for those more experienced or who want to sparring is an option but not obligatory. They are open to anyone of any fitness level and you don't need to have boxed before to join in. Why not come along and bring a mate too? 

If you'd like to find out more about us you can do so below, and also check out some of our fabulous men opening up with Youth Unity about mental health: https://podcasts.apple.com/us/podcast/men-unmasked-conversations-unveiled/id1695537489?i=1000622693026 

You can find out more about my work at www.bethefirstboxing.com and www.thelossproject.com and at Dennis and Dyer Boxing Academy

Or if you'd like to find out more you can contact Carly on 07943 997 827 or socentcarly@gmail.com
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PERSONAL DETAILS

Please provide your personal details to allow us to contact you about matters specific to your training programme or contact your next of kin in case of an emergency.
Full Name *
Address including Postcode *
Date of Birth *
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Email address *
Next of kin details for use in emergencies only: Full name and Number
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I have read, understood and accept the terms and conditions of participating in physical activity at the men's boxing group Please tick to agree to the statement and to commence your exercise participation. 
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PAR-Q (Physical Activity Readiness Questionnaire)
PAR-Q (Physical Activity Readiness Questionnaire)
Many health benefits are associated with regular exercise, and the completion of PAR-Q is a sensible first step to take if you are planning to increase the amount of physical activity in your life. For most people physical activity should not pose any problem or hazard. PAR-Q is designed to identify the small number of adults for whom physical activity might be inappropriate or those who should gain medical advice concerning the type of activity most suitable for them. All information will be kept confidential.

Before any physical activity can begin please complete the following questionnaire by ticking either ‘yes’ or
‘no’. If any answers are 'yes', please provide further detail on your answer at the end of the form.
Have you ever been diagnosed with a heart condition? And that you should only perform physical activity recommended by a doctor?
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Do you suffer from chest pains either at rest, during or after exercise?*
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Have you ever had any significant medical condition? Eg. diabetes, epilepsy, stroke
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Have you ever had any significant surgery or sustained a significant injury?*
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Have you been informed by your doctor that you have bone, joint problems e.g. arthritis that would be aggravated or made worse by participating in physical activity?
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Do you ever lose consciousness, or do you ever lose control of your balance due to chronic dizziness?
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Has a doctor ever told you that you have high blood pressure?*
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Has a doctor ever told you that you have low blood pressure?*
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Has a doctor ever told you or are you aware that you have a high cholesterol level?*
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Do you have any allergies?*
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Are you asthmatic?*
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Are you diabetic?*
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Are you epileptic?*
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Do you or have you ever suffered from unusual shortness of breath with mild exertion?
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Are you or have you been pregnant in the last 6 months?*
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Are you currently taking any prescribed medication? Eg. For blood pressure, heart condition.
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Any other information which you feel will prove helpful in planning your exercise programme or may be caused aggravation by use of the gym equipment?
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Has your doctor given any reason or advised that you may not participate in any physical exercise activity?
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Do you know of any other reason why you should not do physical activity?*
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Tell us why you think the sessions would benefit you
If you have answered 'Yes' to any of the above questions please elaborate your answers in the box below
I have read, understood and accurately completed this questionnaire to the best of my knowledge. I confirm that I am voluntarily engaging in an acceptable level of exercise, and my participation involves a risk of injury. If in doubt, I will look for advice on how to use the equipment safely and perform exercises in a safe manner. If you answered 'Yes' to any of the questions, please confirm that your doctor has agreed that it is safe for you to become physically active at this current time, and in your current state of health. I fully understand that whilst exercising, if I suffer any injury, pain or dizziness, I must stop exercising immediately. I will advise the coaches if any change in my physical condition which may affect my ability to exercise safely. I understand that I use the sessions entirely at my own risk. Please agree below to acknowledge that you have understood and read all of the above and agree to undertake physical activity at your own risk.
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Informed Consent

The purpose of exercising is to help you achieve health and fitness goals. 

You will experience some feelings of exertion during each activity session and will become hot and uncomfortable at times. Your breathing and heart rate will increase as a result of these activities as would be expected from physical exercise of this type.
As your fitness improves, you will participate in more vigorous levels of activity, but these will be within your capabilities.

All activities will be explained and demonstrated where appropriate but please feel free to ask questions about anything you wish.

Any exercise programme carries with it an element of risk. The sessions will be designed to minimise the risks whilst providing an effective exercise/activity intensity.

Please inform us if, for any reason (such as illness or injury which might be aggravated by exercise), you should not participate in an activity.

If at any time, you feel undue pain or excessive discomfort, stop the activity and inform your coach of your symptoms, You are free to withdraw from any activity at any time you wish.

I agree to take part in the programme described to me by the coach. The nature, purpose, risks and benefits
have been explained to me and I understand what is required of me and that I may withdraw at any time.

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