Children's PAR-Q Screening Form

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Child's Name *

Mobile No. *

Child's Date of Birth

Parent / Guardian Name *

Email *

Child's Current Age *

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Emergency Contact - Name *

Emergency Contact - Number *

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If you have answered ‘YES’ to any of the above questions please give full details here and seek medical clearance prior to the session.

DECLARATION

In signing this form, I the parent/guardian of the aforementioned child, affirm that I have read this form in its entirety and I have answered the questions accurately and to the best of my knowledge. I understand that my child/me is responsible for monitoring him or herself throughout any activity, and should any unusual symptoms occur, my child understands the importance of informing the instructor immediately.

You consent to photography being used by Swansea Outdoor Fitness during the activity please make us aware if circumstances deem this is not possible.

I have read, understood and completed this questionnaire and agree to be bound by its conditions. *

Yes
No

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Name *

Date *

GDPR Agreement *

I agree to receive communication from Swansea Outdoor Fitness by email and SMS. *

Children’s PAR-Q Screening Form