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Physical Activity Readiness Questionnaire (PARQ)
Self Certification 

Has your doctor ever said that 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 chest pain when not doing physical activity?
Do you lose balance because of dizziness, or do you ever lose consciousness?
Do you have a bone or joint problem that could be made worse by a change in your physical activity?
Is your doctor currently prescribing any medication for your blood pressure, or for a heart condition?
Are you currently taking any medication of which I should be made aware of?
Are you pregnant, or have you had a baby in the last 6 months?

If you answered “YES” to any questions on the PARQ (Physical Activity Readiness Questionnaire), you are strongly advised to consult a doctor before starting any physical activity or fitness programme.

 

By signing this agreement, I confirm that:

  1. I have chosen to self-certify that I am fit to participate in physical activities with Katie Baron at Body with KB.

  2. I engage in all activities entirely at my own risk and assume full responsibility for any risks of injury, illness, or death that may result from my participation.

 

I fully acknowledge and accept that:

  • Participation in exercise programmes carries inherent risks, including potential injury or health complications.

  • I waive, release, and discharge Katie Baron from all liability arising from participation in any fitness or nutrition programme, including (but not limited to):

a) Injuries sustained during activities, sessions, or use of equipment.

b) Risks associated with guidance, supervision, or dietary recommendations.

 

I confirm that I:

  • Understand and accept this release of liability.

  • Will not hold Katie Baron liable for any claims, causes of action, or damages related to my participation.

  • Will update Katie promptly if my health or medical condition changes and complete a new screening questionnaire if necessary.

 

I have read and understood this document and agree to these terms as a condition of participating in Katie Baron’s fitness and nutrition programmes.

Thanks for submitting!

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