The Physical Activity Readiness Questionnaire for Everyone. Mandatory before participating in Revival Fitness services.
If you answered NO to all of the questions above, you are cleared for physical activity. Please sign the PARTICIPANT DECLARATION.
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.
I, the undersigned, have read, understood to my full satisfaction and completed this 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 centre may retain a copy of this form for its records. In these instances, it will maintain the confidentiality of the same, complying with the applicable law.
If you answered YES to one or more of the questions above, you will need to COMPLETE PAGES 2 AND 3.
A PDF will be provided to you through your email address were you will need to fill it out and submit it to Revival Fitness. Please submit the form and await further instructions.