Are you below the age of 15 or over the age of 69?

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

Do you feel pain in your chest when you do physical activity?

In the past month, have you had a chest pain when you were not doing physical activity?

Do you lose your balance because of dizziness or do you ever lose consciousness?

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?

I acknowledge that in normal circumstances exercise should not harm me in any way. I shall inform my fitness professional of any medical related changes prior to commencing any training session and that JDarPT and their Instructors/Personal Trainers will not be liable in any way for any unforeseen circumstances or for any circumstances of which I should have been aware, but failed to notify them