Aerial Fitness & Fun - Child PAR-Q

JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.

Physical Activity Readiness Questionnaire

Email *

Name of Child *

Name of Parent/ Guardian *

Address *

Telephone Number of Parent/ Guardian *

Date of Birth of Child *

YYYY

What physical activities does your child participate in?

How would you describe your child's general health?
*

Excellent

Very good

Good

Fair

Poor

Does your child suffer from any respiratory disorders?
*

Yes

Does your child suffer from any heart conditions?
*

Yes

Does your child suffer from dizzy spells, fainting or balance problems?
*

Yes

Does your child currently have any physical conditions?
*

Yes

Please indicate any other health problems that we should be aware of (recent operations, injuries etc)

Does your child suffer from any mental health issues?
*

Yes

(Optional) If you have answered yes to the above, please disclose the nature of the issue

If you have answered yes to any of the above questions, please ensure that you have discussed your child’s ability to participate in these aerial activities with their doctor or GP before submitting this PAR-Q.

I confirm that any issues will be discussed with a doctor before completing this form

All measures have been taken to minimise the risks involved in aerial fitness, however the risk cannot be eliminated completely. By signing this, you state that you understand that in participating in aerial fitness classes your child may experience some bruising, sore muscles and sore hands

I understand the risks outlined above

Required

In addition, during the lesson the instructor may need to physically assist your child in or out of the apparatus. This will be carried out using specific spotting techniques details of which will be available on request.

I understand and accept that my child may be physically assisted by the instructor

Required

If there are any changes to the above information you must advise Aerial Fitness and Fun immediately.
*

If mine or my child's information changes, I will inform Aerial Fitness and Fun immediately

Required

I confirm that I have answered all questions to the best of my knowledge and the information is correct.
*

The information I have provided is correct to the best of my knowledge

Required

Aerial fitness and fun will hold your information in accordance with current GDPR legislation. By providing this information you consent to the using of your data in order for us to administer your lessons. Your details will not be forwarded to any third parties.

I consent to Aerial Fitness and Fun using my data in order to administer my lessons

Required

Submit

Clear form

Never submit passwords through Google Forms.

This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy

Forms