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MEDICAL DISCLAIMER & CONSENT FORM
Name
Email
Phone
Address
Date of birth
Date of Paddleboarding activity
Name of Lead Booker
Emergency contact name
In case of emergency contact number
Previous relevant experience
How would you describe your fitness level?
Are you able to swim?
Are you on any medication? If so please detail what and why.
Do you suffer from asthma or have any other breathing difficulties?
Please advise of any allergies
Do you suffer from diabetes, epilepsy, or a mental disorder?
Do you often feel faint or have spells of dizziness?
Are you pre/post-natal?
I confirm I have no history of heart problems, chest pains, strokes, high blood pressure, angina, or other cardio conditions that I have been advised by doctors could be aggravated by exercising?
I confirm I have no history of muscular, joint, bone conditions that I have been advised by a doctor could be aggravated by excercise?
I confirm I have no history of other chronic illness or conditions that you have been advised by a doctor could be aggravated by exercise?
If you have answered yes to any of the above questions you confirm that you have sought medical advice and they are happy for you to take part in an exercise program?
I will bring any medication I need on my person (inhaler, epi-pen etc) with me for the session.
I am below 110kg in weight (Note the maximum weight we can take on our standard boards is 110kg)
Any other issues that you need to inform us of which may have an impact on your ability to paddleboard?
Date of completing form
I have read, understood and agree to the Terms & Conditions
View Terms
I have read, understood and agree to the risk and consent form
View Terms
Send
Thanks for submitting!
Where we are ...
Ferry View Estate, Horning
Norfolk NR12 8PT
info@gopaddle.co.uk
01603 339105
https://w3w.co/impulses.whoever.inflates
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