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(@BZ    Z hIZ  4   ` #"l@@@``@B ( ( (? (@BZ  sZ W0 B Z hJZ  4   `#"l@@@@@@B?@BZ 5 6 0 `]HZ hXZ  4    `#"l@@@``@B ( ( (? (@BZ 5 cp `/ `]HZ h)Z  4 !  `#"l@@@``@B ( ( (? (@BZ N E `" }Z h9Z  4 "  `#"l@@@``@B ( ( (? (@BZ '# E 0 Z hPZ  4 #  `#"l@@@``@B ( ( (? (@BZ  S  0Z hQZ   $ T0"`@@@BK @BZ  A 0 v3Z h6Z  CHNKINK DBTEXTTEXTSTSHSTSHFSTSHSTSH STSHSTSH!FDPPFDPP$FDPPFDPP&FDPPFDPP(FDPCFDPC*FDPCFDPC,FDPCFDPC.FDPCFDPC0FDPCFDPC2FDPCFDPC4SYIDSYID6,SGP SGP ,6INK INK 06BTEPPLC 46(BTECPLC \6@FONTFONT6Full Name: Address: Post Code: Date of Birth: Landline: Mobile: Email: Class Venue: Date of Joining: WHAT ARE YOUR MOTIVES FOR EXERCISING? Registration form and Physical Activity Readiness Questionnaire (PAR-Q) Body Boost I HAVE READ, UNDERSTOOD AND COMPLETED THIS QUESTIONNAIRE. Please note, for insurance purposes, attendance at these classes is entirely at your own risk with regard to personal injury or loss of property. PRINT NAME: SIGNATURE: DATE: IF YOU HAVE ANSWERED YES TO ONE OR MORE QUESTIONS, it may be necessary to talk to your doctor by phone or in person before you start becoming more physically active. Tell your doctor about the questions you have answered YES to. IF YOU HAVE ANSWERED NO TO ALL QUESTIONS, you can be reasonably sure that you can start to become more physically active and take part in a suitable exercise programme. Remember to begin slowly and build up gradually. PLEASE NOTE If your health changes so that subsequently you answer YES to any of the above questions, inform your fitness or health professional immediately. Has your doctor ever said that you have a heart condition and that you should only do physical activity recommended by a doctor? Do you ever feel pain in your chest when you do physical activity? Have you ever had chest pain when you are not doing physical activity? Do you ever feel faint or have spells of dizziness? Do you have a joint problem that could be made worse by exercise? Have you ever been told that you have high blood pressure? Are you currently taking any medication of which the instructor should be made aware? If so what? __________________________________________________ Are you pregnant or have you had a baby in the last 6 months? Is there any other reason why you should not participate in physical activity?& & .If so what? __________________________________________________ YES/NO YES/NO YES/NO YES/NO YES/NO YES/NO YES/NO YES/NO YES/NO Registration form and Physical Activity Readiness Questionnaire (PAR-Q) All information will be kept confidential Terms & Conditions Body Boost offers safe and effective Pilates training and Health and Fitness information to all its clients. Your instructor is suitable qualified and insured and is a member of the Register of Exercise Professions. Please read the following terms and conditions before undertaking any session. Acceptance will depend on the completion of a Physical Activity Readiness Questionnaire (PAR-Q) and GP letter (if necessary) Guidelines ONLY are given regarding healthy eating, for specific nutritional advice you need to seek a specialist. Any exercise programme carries with it an element of risk, by signing this Terms and Condition form you become aware of these and give your permission to take part. 2dg &, dg(8@P\ "$b          !"#$'(,9"D " " "$b          !"#$'(,9"D " " "vB$b          !"#$'(,9"vBD " " "\K$b          !"#$'(,9"\KD "0 "|$l          !"#$'(,9"|D "0 dg(8HXhx Are you currently taking any medication of which the instructor should be made aware? 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