I hereby declare:

I have consulted my doctor and my physical condition is suitable to participate in the {0}.

Declaration by applicants with hypertension or diabetes

I declare “My physical condition is suitable for participating in exercise and gym training. Yuen Long District Health Centre shall not be liable for any injury or death caused by personal negligence or poor health / physical fitness during this activity."

Points to note:
Participants should pay attention to their physical condition and consider whether you are fit to join in this activity. If you have any recent medical conditions or injuries, please seek medical advice in advance to see if you are suitable to participate.

NO to all questions
If you answered NO honestly to all PAR-Q questions, you can be reasonably sure that you can:

- start becoming much more physically active – begin slowly and build up gradually. This is the safest and easiest way to go.

- take part in a fitness appraisal – this is an excellent way to determine your basic fitness so that you can plan the best way for you to live actively. It is also highly recommended that you have your blood pressure evaluated. If your reading is over 144/94, talk with your doctor before you start becoming much more physically active.

DELAY BECOMING MUCH MORE ACTIVE：
- if you are not feeling well because of a temporary illness such as a cold or a fever – wait until you feel better; or
- if you are or may be pregnant – talk to your doctor before you start becoming more active.

PLEASE NOTE: If your health changes so that you then answer YES to any of the above questions, tell your fitness or health professional. Ask whether you should change your physical activity plan.

I have read, understood and completed this questionnaire. Any questions I had were answered to my full satisfaction.

Network Service Providers (Operator)

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