Simon Beatson Personal Training and Sports Therapy

BOA BOOTCAMP BOOKING FORM

Great news that your child wishes to come along to a class.

Before they attend their first class, I'd be very grateful if you could provide me with a few basic details about them and answer the PARQ (Physical Activity Readiness Questionnaire) questions below to ensure they can take part safely.

Doing this in advance will save us lots of time before the class, so thank you for making the effort.

Once I've received your form their free trial place is secure, and I look forward to seeing them at a class very soon!

Child's name

First Name

Last Name

Supervising parent's name

All under 18s attending a BOA Bootcamp class must be accompanied by an adult

First Name

Last Name

I agree to accompany my child to all BOA Bootcamp classes they attend

I agree

When does your child wish to attend for their free trial?

YYYY

Which location will you attend?

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Email Address

Phone number

Gender

Date of birth

YYYY

Relationship of supervising parent/carer

Phone number for supervising parent/carer

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 people for whom physical activity might be inappropriate or those who should have medical advice concerning the type of activity most suitable for them.

Does your child have a bone or joint problem that may be made worse with exercise?

Does your child have high blood pressure?

Does your child have low blood pressure?

Does your child have a heart condition or is there any history of heart problems in their family?

Has your child ever felt pain in their chest when doing exercise?

Has your child ever suffered from asthma or unusual shortness of breath at rest, or with exertion?

Does your child have Diabetes or any other metabolic disease?

Has your child ever felt faint, had spells of severe dizziness or lost consciousness?

Has your child been advised to only do physical activity recommended by a doctor?

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

If you answered 'yes' to one or more questions:

If they have not recently done so, your child should consult with their doctor by telephone or in person before increasing their physical activity and/or taking a fitness appraisal. Seek advice from a doctor as to their suitability for: 1: Unrestricted physical activity starting off easily and progressing gradually. OR 2: Restricted or supervised activity to meet their specific needs, at least on an initial basis.

If you answered 'no' to all questions:

If you answered PAR‐Q accurately, your child will have reasonable assurance of their present suitability for a fitness appraisal and graduated exercise programme. Please note that even if they answered ‘no’ to all questions, they should delay becoming more active if they are temporarily ill, or their health status changes. If their health changes so that they then answer ‘yes’ to any of the above questions, tell their doctor and ask Simon Beatson PT whether they should change their physical activity plan.

Confirmation

I hereby state that I have read, understood and answered honestly the questions on the PAR‐Q on behalf of my child. I also state that I wish for my child to participate in physical activity with a personal trainer, and agree that they do so entirely at their own risk. I realise that their participation in these activities involves risk of injury, illness and even the possibility of death. Furthermore, I hereby confirm that they are voluntarily engaging in an acceptable level of exercise, which has been recommended to them. Participants who answered 'yes' to one or more question also confirm that they have taken medical advice and the doctor has agreed that they should exercise.

Date

YYYY

DATA USE: I confirm that I am happy to share the above health and contact data information, and for it to be held on file and used for the purposes of providing safe and effective sessions and for keeping me up-to-date with any news about the training relationship and/or Simon Beatson Personal Training, now and in the future. *

BOA BOOTCAMP BOOKING FORM

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