Step 2

Participation Declaration

All persons who have completed the PAR-Q+ Questionnaire with ALL NO responses, Please read and sign the declaration below.
If you are less than the legal age required for consent or require the assent of a care provider, your parent, guardian or care provider must also sign this form.

First name

Last name

Phone

I, the undersigned, have read, understood to my full satisfaction and completed the PAR-Q+ questionnaire. I acknowledge that this physical activity clearance is valid for a maximum of 12 months from the date it is completed and becomes invalid if my condition changes. I also acknowledge that the community/fitness center/trainer may retain a copy of this form for records. In these instances, it will maintain the confidentiality of the same, complying with applicable law.

I have completed the PAR-Q+ Questionnaire with ALL NO responses.

Signature of Participant / Parent / Guardian / Care Provider

Signature field is empty.

Step 3