Description
Thank you for booking on to the Once in a Pink Moon event with Hilary Westlake and Jo Rees .
PLEASE COMPLETE THE HEALTH QUESTIONNAIRE ON BOOKING THE CLASS AND EMAIL IT TO HILARY AND JO AT :
hilarywestlake3@gmail.com
YOU ONLY NEED TO COMPLETE THIS IF YOU HAVEN’T COMPLETED ONE FOR HILARY BEFORE OR IF INFORMATION HAS CHANGED!
…………………………………………………
Health and Safety Questionnaire – Physical Activity Readiness Questionnaire (PAR-Q)
1. Name:
2. DOB:
3. Occupation:
4. Emergency Contact:
Q1) Do you suffer from any medical/health conditions that might affect your ability to exercise?
Q2) Do you have any specific problem areas that cause you pain (even if mild)?
Q3) Have you ever been advised by a doctor not to exercise?
Q4) Have you recently had an illness or operation? Please provide details.
Q5) Are you pregnant?
Q6) Please describe your experience of YOGA to date?
Q7) What are you hoping to achieve/what are your goals?
Q8) Is there anything else I need to know?
…………………………………………………….Please note: If anything changes regarding your health or ability to exercise, please inform Hilary immediately (before/during a session).
If there is any query regarding your health and/or ability to exercise, you are advised to seek medical advice as soon as possible. By signing this form, it is assumed you have taken all necessary steps to ensure your health and safety to attend a session with Hilary. She accepts no responsibility based on this.
Signed: ______________________
Date: ______________________
Reviews
There are no reviews yet.