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Health Questionnaire

Health Declaration

Please fill out the following form in order to participate in our activity.

Do you have any illness or injury or know of any other reason that prevents you from safely exercising?
Has your Doctor or any other health professional said that you should not exercise?
Do you feel pain in your chest when you perform physical activity?
In the past month have you experienced chest pain when not exercising?
Do you have high or low blood pressure
Do you lose your balance due to dizziness or do you ever lose consciousness?
Do you have any joint, bone or muscle injuries?
Do you have any dietary requirements or food allergies?

Thanks for submitting!

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