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Home
About
Executive & Committees
Life Members
A Grade Honour Roll
Join Us
Shop
Sponsors
News
Contact Us
Home
About
Executive & Committees
Life Members
A Grade Honour Roll
Join Us
Shop
Sponsors
News
Contact Us
PAR-Q TRAINING & COVID ATTENDANCE
PARRAMATTA REFEREESÂ 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
NO
Have you been in contact with a casual or confirmed COVID-19 case in the last 14 days?
YES
NO
Have you been overseas or to a COVID-19 hotspot in the last 14 days?
YES
NO
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
NO
PAR-Q CLEARANCE
Do you feel pain in your chest when you do physical activity?
*
YES
NO
In the past month, have you had chest pain when you were not doing physical activity?
*
YES
NO
Has your doctor ever said that you have a heart condition and that you should only do physical activity recommended by a doctor?
*
YES
NO
Do you have a bone or joint problem that could be made worse by a change in your physical activity?
*
YES
NO
Is your doctor currently prescribing drugs (for example, water pills) for your blood pressure or heart condition?
*
YES
NO
Do you lose your balance because of dizziness or do you ever lose consciousness?
*
YES
NO
Do you know of any other reason why you should not do physical activity?
*
YES
NO
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.
Signature
*
Submit
Form Submitted Successfully!
Your training attendance has been recorded