Parramatta District Referees | PAR-Q TRAINING & COVID ATTENDANCE

PARRAMATTA REFEREES PAR-Q TRAINING & COVID ATTENDANCE

Your First Name *

Your Last Name *

Please enter your phone number *

COVID CLEARANCE

Have you had COVID-19 symptoms in the last 14 days?

YES

Have you been in contact with a casual or confirmed COVID-19 case in the last 14 days?

YES

Have you been overseas or to a COVID-19 hotspot in the last 14 days?

YES

IF YOU ANSWERED YES TO ANY OF THE ABOVE QUESTIONS YOU MUST LEAVE THE VENUE IMMEDIATELY

Do you agree to comply with all Parramatta Referees & government COVID-19 regulations?

YES

PAR-Q CLEARANCE

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

YES

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

YES

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

YES

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

YES

Is your doctor currently prescribing drugs (for example, water pills) for your blood pressure or heart condition? *

YES

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

YES

Do you know of any other reason why you should not do physical activity? *

YES

If You Answered Yes

If you answered yes to one or more questions, are older than age 40, and have been inactive or are concerned about your health, consult a physician before taking a fitness test or substantially increasing your physical activity.

If You Answered No

If you answered no to all the PAR-Q questions, you can be reasonably sure that you can exercise safely and have a low risk of having any medical complications from exercise. It is still important to start slowly and increase gradually. It may also be helpful to have a fitness assessment with a personal trainer or coach in order to determine where to begin.

Keep in mind that if your health changes so that you then answer "Yes" to any of the PAR-Q questions, tell your fitness or health professional. You may need to change your physical activity plan.

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 Parramatta Referees will retain a copy of this form for its records. In these instances, it will maintain the confidentiality of the same, complying with applicable laws.

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