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Pre-exercise Screening & Questionnaire Form

Pre-exercise Screening & Questionnaire Form

Medical Information

Has your medical practitioner ever said that you have a heart condition or should only do physical activity recommended by a doctor?
Has your medical practitioner ever said that you have signs/symptoms of a stroke or have you ever suffered a stroke?
At rest or during physical activity, do you ever feel pain/discomfort in your chest?
At rest or during physical activity, do you ever lose your balance, feel faint, dizzy or lose consciousness?
Do you have asthma? Have you had an asthma attack that required immediate medical attention, within the past 12 months?
Do you have diabetes? If yes, have you had trouble, controlling your blood sugar/glucose levels, within the past 3 months?
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 drugs or medications for your blood pressure, heart conditions or any other conditions?
Are you aware of any other reasons you may not participate in physical activity?
Are you aware of your Weight, Height, Body Mass Index (BMI), Resting and Maximum Heart rate & Blood pressure?
If Required, may we conduct tests in order to help create a program? (Referral may be required)
Do you currently discuss or trade information with any other health professional?

Goals & Exercise History

Acknowledgment, Release, And Indemnification Agreement

Session Cancellation Policy:
I understand that I must notify ARTOC Family at least 12 hours prior to a scheduled session/class to request cancellation or rescheduling.
Assumption Of Responsibility:
I acknowledge that I am solely responsible for my own/my child’s state of being and well-being during and outside of training sessions. I agree to notify the coach immediately in the event of any pain, injury, or discomfort.
Voluntary Participation & Assumption Of Risk:
I acknowledge that participation in recreational activities provided by ARTOC Family is entirely voluntary. By allowing myself/my child to participate, I accept all risks involved, including those associated with any pre-existing health conditions.
Media Recording and Publishing Consent:
I grant ARTOC Family permission to photograph, videotape, or record my/my child’s likeness, voice, and performance during activities. I also grant ARTOC Family the right to use these recordings in any media (e.g., website, social media, promotional materials) for any lawful purpose, without compensation or notification. I waive any rights to inspect or approve the final product.
Release Of Liability:
I release and hold harmless ARTOC Family, its officers, directors, employees, agents, and affiliates from any and all liability for any injury, harm, or damage that may occur to me or my child during or outside of training sessions.
Indemnity Agreement:
I agree to indemnify and hold harmless ARTOC Family, its officers, directors, employees, agents, and affiliates against any and all liability for:
– Any injury, harm, loss, damage, or death suffered by myself/child
– Any damage, loss, or destruction of property and/or possessions
– Any medical expenses, hospitalization, or recovery costs
– Any other costs, expenses, or claims arising from or related to my/my child’s participation in recreational activities provided by ARTOC Family
By submitting this form, I acknowledge that I have read, understand, and agree to the terms and conditions outlined above.
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ARTOC provides members with a systematic method to bodyweight movement.
We help you develop the strength and skills required to master the ART of Calisthenics and ultimately achieve your goals.

Working hours

Monday – Friday:
06:00 AM – 10:00 AM
03:00 PM – 09:00 PM

Saturday:
06:00 AM – 08:00PM

Sunday:
Closed

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