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Evolve Studios PAR-Q & Health Questionnaire

Please read carefully and complete honestly before participating in any class, session, or service at Evolve Studios.

Your Details

First Name

Last Name

Date of Birth

Day

Month

Year

Email

Phone

Health Screening

Please read carefully and answer each question HONESTLY, providing additional details where relevant.

Are you new to exercise?

Yes

No

If No, what physical exercise do you regularly participate in?

Has a doctor or healthcare professional ever advised you to avoid, limit or modify exercise?

No

Yes

Do you have any diagnosed medical conditions, past surgeries, illnesses or injuries?

Do you currently have any medical concerns, injuries, or difficulties?

Do you currently experience any of the following? (Past 3 months)

Are you currently taking any medications?

No

Yes

Are you currently pregnant, recently post-natal, or within 12 months of giving birth?

No

Yes

Do you have any food allergies? (For occasions and events where we may serve food and drink)

Emergency Contact Name:

Emergency Contact Number

If your emergency contact number matches your own number, you will be asked to re-submit this form.

Declaration

I confirm the information provided is accurate to the best of my knowledge and I agree to inform Evolve Studios of any changes to my health, medications, injuries, pregnancy status or medical conditions.

By signing this document, I acknowledge that participation in physical exercise and fitness activities carries inherent risks. I voluntarily assume responsibility for my participation and for managing my own health and wellbeing during sessions, and agree to cease participation if unusual symptoms occur.

I agree that Evolve Studios Skegness, its owner, instructors, and staff shall not be held liable for injury, illness, loss, or damage arising from my participation, except where liability cannot be excluded by law.

Signature

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