You have been asked to complete this additional form during the ‘Physical Activity Readiness Screening (PARS)’ process as you answered Yes to one or more question(s) within ‘SECTION C – Medical Questions of the form’. Based on your responses to those questions, we advised you NOT to take part in physical exercise without first gaining the consent and advice of my/their Doctor. By completing this form you are disregarding this advice and commencing physical activity without first consulting your Doctor. You therefore assume risk and liability for doing so.

As per the PARS form, details provided below should relate to the person wishing to commence physical activity. Parents, guardians or carers should complete the details for those under 18 years of age.