Full Name *Email *Phone *Date of Birth *01-JAN-2024Event Type *Select1 Star2 StarKOPEskimo Roll ClinicKayak rentalDate(s) of Event: *Input all the dates for the eventRegular physical activity is fun and healthy, and increasingly more people are starting to become more active every day. Being more active is very safe for most people. However, some people should check with their doctor before they start becoming more physically active. If you are planning to become more physically active than you are now, start by answering the 7 questions below. If you are between the age of 11 and 69, the PAR-Q will tell you if you should check with your doctor before you start. If you are over 69 years of age, and you are not used to being very active, check with your doctor first. Common sense is your best guide when you answer this questions. Please read the questions carefully and answer each one honestly: Check Yes or No.1. Has your doctor ever said that you have a heart condition and that you should only do physical activity recommended by a doctor? *YesNo2. Do you feel pain in your heart or chest when you do physical activity? *YesNo3. In the past month, have you had heart or chest pain when you were not doing physical activity? *YesNo4. Do you lose your balance because of dizziness or do you ever lose consciousness? *YesNo5. Do you have a bone or joint problem (for example, back, knee or hip) that could be made worse by a change in your physical activity? *YesNo6. Is your doctor proscribing drugs (for example water pills) for your blood pressure or heart condition? *YesNo7. Do you know of any good reason why you should not do physical activity? *YesNoIf you answered “Yes” to any of the above questions, you are highly recommended to consult your doctor before beginning this program. Tell your doctor about the questions which you answered Yes. If you answered “No” honestly to all the questions, you can be fairly sure that you can become more physically active and take part in a fitness program or training. However, if you are or may be pregnant, consult your doctor before becoming more active. In addition, should your health changes such that you then answer “Yes” to any of the above questions, do tell your fitness professional and ask whether you should change your physical activity plan. I have read, understood, and completed this questionnaire. Any questions I had were answered to my full satisfaction.Indemnity *1. I accept full responsibility for my medical status and personal safety. I declare that I do not have any impairment or disability or condition that may put me at risk.2. I accept that my voluntary participation in this event carries a foreseeable risk of accidents, personal injuries, death and losses of any kind.3. I accept that XTREME KAYAKING, and all appointed agents and volunteers are excluded from all liabilities for any accidents, loss of belongings, damages, personal injuries, death, or losses of any kind that may arise from or as a result of this event.TAKE NOTICE THAT XTREME KAYAKING are totally excluded of any liability for personal injury or death that may arise due to your participation in Kayaking. Personal Responsibility, Exclusion of Liability and IndemnityRegister
