New participant registration form

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Participant details

Date of Birth(Required)

Participant contact information

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Emergency contact

Fitness to exercise

Has your doctor ever said that you have an heart condition?(Required)
Do you feel pain in your chest when do you physical activity?(Required)
In the last month, have you had pain in your chest when not doing physical activity?(Required)
Do you ever lose balance because of dizziness or ever lose consciousness?(Required)
Do you ever get short of breath when walking on level ground?(Required)
Do you suffer from Asthma or Bronchitis?(Required)
Do you have Diabetes?(Required)
Do you have any bone or joint problems which could be made worse by increased physical activity?(Required)
Do you get continuous pain in the calf when walking?(Required)
Have you have any other serious illnesses or been in hospital in the last 12 months?(Required)
I understand that if I have answered yes to any of the above I should seek medical advice before taking part in an exercise session. I agree to tell the class leader if there is a change in my medical condition and medication. I accept that I am exercising at own risk.(Required)

Declarations

I understand that photographs/video taken may be used by Fit4All/Fit4All Group. I understand that all or parts of the photographs/video may be used by Fit4All as form of illustration within by not limited to publications, journals, advertising, website, social media and in any other form or medium for distribution anywhere in the world. As a result, I understand that the general public worldwide may see the images or video. I understand that I will not be identified by name within any of the publications, website or other media. Do you give permission for photographs to be taken?(Required)
I understand that the information given on this form will be used by Fit4All for monitoring purposes and to send you information. Your data will be processed in line with the data protection act (GDPR) and our own data protection policy. Information disclosed on this form must be correct to the best of your knowledge and at any time your details change you need to inform Fit4All. Our full data protection policy can be viewed at on our website. Do you accept Fit4All's data protection statement?(Required)
I declare that to the best of my knowledge the information disclosed on this form is accurate and correct. I declare that I have accepted all the relevant policies outlined on this form and by selecting this I agree to them. I declare that I no reason why I should not participate in this service/activity.(Required)
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