PARTICIPANT QUESTIONNAIRE

You must complete the online tool which is available hereYou do not need to print that form or send it to us.  Once you've answered the questions, provided you do not require additional information or permissions from a medical professional, please then read and acknowledge the following:

I, the undersigned, have read, understood to my full satisfaction and completed the Par-Q online form. I have answered each question truthfully, reflecting my current condition. I acknowledge that this physical activity clearance/recommendation 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 KK Pinkowski may, if required, maintain a copy of this form as Trustee for her records, if requested.  In these instances, she will, as Trustee, be required to adhere to Canadian and International guidelines regarding the storage of personal health information ensuring that she maintains the privacy of the information and she agrees that she will not misuse or wrongfully disclose such information.    

The authors, the PAR-Q+ Collaboration, partner organizations, and their agents assume no liability for persons who undertake physical activity.

If in doubt after completing the questionnaire, consult your doctor prior to physical activity.       

I acknowledge that by submitting this form, my name typewritten below shall be in lieu of my handwritten signature but shall be of the same force and effect as though I had signed the same in ink.

 
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Female Basketball Player