No Limits On Line Run Class Questionnaire

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* 1. Please complete the following

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* 2. What event are you training for?

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* 3. What is your current run fitness?

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* 4. What type of runner are you?

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* 5. What days do you want to run on (pick up to three)

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* 6. Do you have any current injures or physical limitations that we should be aware of?

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* 7. Are you currently running with a group during the week?

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* 8. Par - Q (please complete the following questions)

  Yes No
Has your doctor ever said that you have a heart condition and that you should only do physical activity recommended by a doctor? Yes or No?
Do you feel pain in your chest when you do physical activity? Yes or No
In the past month, have you had chest pain when you were not doing physical activity? Yes or No
Do you lose your balance because of dizziness or do you ever lose consciousness? Yes or No
Do you have a bone or joint problem (for example, back, knee or hip) that could be made worse by a change in your physical activity? Yes or No
Is your doctor currently prescribing drugs (for example, water pills) for your blood pressure or heart condition? Yes or No
Do you know of any other reason why you should not do physical activity? Yes or No
Is the information you have entered in this questionnaire accurate and true? (NOTE YOU SHOULD ANSWER YES HERE)

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