Health Form

Please complete the following registration form. It will take just 5 minutes and you will be ready to train.

Registration Form

Step 1 of 3

Your Details

Title(required)

First Name(required)

Surname(required)

Address 1(required)

Address 2

Address 3

Town(required)

County(required)

Postcode(required)

About You

Age(required)

Height(required)

Body weight?(required)

Contact Details

We require at least one telephone number.

Primary Contact Telephone No.(required)

Secondary Contact Telephone No.

Email(required)

Confirm Email(required)

In the case of emergency your contact person is:

Name(required)

Telephone(required)

How did you hear about Alexandra Merisoiu?

I first heard from(required)

Step 2 of 3

PAR-Q (Physical Activity Readiness Questionnairea)

Fitness

How often do you train?(required)

When was the last time you regularly trained?(required)

How would you describe your current fitness level(required) Unfit

Returning to fitness training

Fit

Very Fit

Current & Past Training

Please let us know your goal, event or reason for training

I am training for:

Step 3 of 3

The last few questions…

Health

Has your doctor advised you that you should not do any physical exercise or training(required) Yes

Are you post natal?(required) Yes

Do you suffer from asthma, or breathing difficulties?(required) Yes

Have you been in hospital in the last 3 years?(required) Yes

Are you taking any medication?(required) Yes

Do you suffer from diabetes or epilepsy?(required) Yes

Do you suffer from an allergy?(required) Yes

Has your doctor ever said that you have a heart condition and that you should only do physical activity recommended by a doctor?(required) Yes

Do you feel pain in your chest when you do physical activity?(required) Yes

In the past month, have you had chest pain when you were not doing physical activity?(required) Yes

Do you lose your balance because of dizziness or do you ever lose consciousness?(required) Yes

Do you have a bone or joint problem that could be made worse by a change in your physical activity?(required) Yes

Is your doctor currently prescribing drugs (ex. water pills) for your blood pressure or heart condition?(required) Yes

Do you know of any other reason why you should not do physical activity?(required) Yes

If you answered yes to any of the above questions , please provide more information:

If you answered:

Yes to one or more questions

Talk with your doctor by phone or in person before you start becoming much more physically active and before you start training. Tell your doctor about the PAR-Q, your intended training and which question(s) you answered YES.
You may be able to do any activity you want as long as you start slowly and build up gradually. Or, you may need to restrict your activities to those which are safe for you. Talk with your doctor about the kinds of activities you wish to participate in and follow his/her advise.

No to all questions

If you answered NO honestly to all PAR-Q questions, you can be reasonably sure that you can:

Start becoming more physically active – begin slowly and build up gradually. This is the safest and easiest way to go.
Take part in an exploratory session to use as a fitness appraisal – this is an excellent way to determine your basic fitness so that you can plan the best way for you to live actively.

Delay becoming much more active:

If you are not feeling well because of a temporary illness such as a cold or fever – wait until you feel better.
If you are pregnant – talk to your doctor before you start becoming more active.
If your health changes so that you then answer YES to any of the above questions, consult your doctor. Similarly, if at any stage your details change, then it is your responsibility to complete a new PAR-Q Form.

Membership Terms and Conditions

Disclaimer

Please read the following documents before proceeding:

The full Disclaimer which includes ‘Risk Factors’ click here.

I understand that participation in training activities involves a certain degree of risk and can be physically, mentally, and emotionally demanding or can even lead to death. I also understand that participation in these activities is entirely voluntary and requires participants to abide by applicable rules and standards of conduct. (required)

This form has been completed accurately to the best of my knowledge and belief.(required)

I have read, understood and completed this form and by ticking this box I agree to be bound by its conditions.(required)

I have read and agree to the Disclaimer(required)

I understand that the deposit is non-refundable and I have to pay the rest of the amount requested 60 days before arrival(required)

I have read and understood the event itinerary, what is included and what it is not included, accommodation conditions, location and everything written about the event and I agree with it(required)

Thank you for completing your Registration booking form.

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